Atrophic vaginitis is a condition in which the tissues that line the vagina become dry and thin. This condition is most common in women who have stopped having regular menstrual periods (menopause). This usually starts when a woman is 45–55 years old.
Estrogen helps to keep the vagina moist. It stimulates the vagina to produce a clear fluid that lubricates the vagina for sexual intercourse. This fluid also protects the vagina from infection. Lack of estrogen can cause the lining of the vagina to get thinner and dryer. The vagina may also shrink in size. It may become less elastic. Atrophic vaginitis tends to get worse over time as a woman’s estrogen level drops.
This condition is caused by the normal drop in estrogen that happens around the time of menopause.
- Taking medicine that blocks estrogen.
- Having ovaries removed surgically.
- Being treated for cancer with X-ray treatment (radiation) or medicines (chemotherapy).
- Exercising very hard and often.
- Having an eating disorder (anorexia).
- Giving birth or breastfeeding.
- Being over the age of 50.
- Pain, soreness, or bleeding during sexual intercourse (dyspareunia).
- Vaginal burning, irritation, or itching.
- Pain or bleeding during a vaginal examination using a speculum (pelvic exam).
- Loss of interest in sexual activity.
- Having burning pain when passing urine.
- Vaginal discharge that is brown or yellow.
- In some cases, there are no symptoms.
- A medical history.
- A pelvic exam that checks whether the inside of your vagina appears pale, thin, or dry.
- Rarely, you may also have other tests, including:
- A urine test.
- A test that checks the acid balance in your vaginal fluid (acid balance test).
- Using an over-the-counter vaginal lubricant before you have sexual intercourse.
- Using a long-acting vaginal moisturizer.
- Using low-dose vaginal estrogen for moderate to severe symptoms that do not respond to other treatments. Options include creams, tablets, and inserts (vaginal rings). Before using vaginal estrogen, tell your health care provider if you have a history of:
- Breast cancer.
- Endometrial cancer.
- Blood clots.
- Taking medicines. You may be able to take a daily pill for dyspareunia. Discuss all of the risks of this medicine with your health care provider. It is usually not recommended for women who have a family history of breast cancer.
- If your symptoms are very mild and you are not sexually active, you may not need treatment.
Follow these instructions at home:
- Take medicines only as directed by your health care provider. Do not use herbal or alternative medicines unless your health care provider says that you can.
- Use over-the-counter creams, lubricants, or moisturizers for dryness only as directed by your health care provider.
- If your atrophic vaginitis is caused by menopause, discuss all of your menopausal symptoms and treatment options with your health care provider.
- Do not douche.
- Do not use products that can make your vagina dry. These include:
- Scented feminine sprays.
- Scented tampons.
- Scented soaps.
- If it hurts to have sex, talk with your sexual partner.
Contact a health care provider if:
- Your discharge looks different than normal.
- Your vagina has an unusual smell.
- You have new symptoms.
- Your symptoms do not improve with treatment.
- Your symptoms get worse.
This information is not intended to replace advice given to you by your health care provider.