Atrophic Vaginitis

Question 1

What is atrophic vaginitis?

Answer 1

Vaginal irritation caused by thinning of epithelium.

Question 2

What is the aetiology of atrophic vaginitis?

Answer 2

Caused by reduction in circulating oestrogen levels. Menopause, prolonged lactation.

Question 3

What is the epidemiology of atrophic vaginitis?

Answer 3

10-40% of postmenopausal women.

Question 4

What is the history/ exam of atrophic vaginitis?

Answer 4

Vaginal irritation, dyspareunia, superficial dysuria, bloodstained discharge.

Pale, thin vaginal walls. Loss of rugal folds. Cracks and fissures.

Question 5

What investigations do you do for atrophic vaginitis?

Answer 5

Swabs may be taken for superimpose dinfection risk. Any suspicious lesions warrant exclusion of malignancy. Presentation with bleeding investiagte as PMB.

Systemic HRT or topical oestrogens.

Question 6

What is the management of atrophic vaginitis?

Answer 6

Systemic HRT or topical oestrogens.

Question 7

What are the complications/ prognosis of atrophic vaginitis?

Answer 7

Increased risk of infection due to loss of acid pH. Substantial relief can be achieved with treatment.