Atrophic Vaginitis

Question 1

What causes atrophic vaginitis?

Answer 1

Declining oestrogen levels, usually as a result of menopause, BSO, or chemo/radiation therapy.

Question 2

What are the signs and symptoms of atrophic vaginitis?

Answer 2

Vaginal dryness
Itching
Burning
Dyspareunia
Increased urinary symptoms

Question 3

How is it diagnosed?

Answer 3

History of symptoms
Physical exam

Question 4

How is atrophic vaginitis treated?

Answer 4

HRT - systemic or local
Oestrogen cream - estriol (ovestin)
Vaginal tablet - vagifem
Vaginal moisturisers
Can be done at bedtime to avoid leakage

Question 5

Any complications of treatment?

Answer 5

Estrogen cream, although uncommon, can cause breast tenderness.

Question 6

Topical HRT - 5 facts

Answer 6

1. Rings, tablets and creams
2. Improves urinary symptoms, including incontinence and nocturia
3. No evidence of endometrial changes, does not require progesterone in addition
4. Symptoms usually improve in less than 3 weeks, but max improvement is seen around 3 months
5. Need to contact doctor if experiencing any PV bleeding