Sexual Health - Atrophic vaginitis

Question 1

What is atrophic vaginitis?

Answer 1

Dryness and atrophy of vaginal mucosa due to lack of oestrogen

Question 2

What is the physiology of atrophic vaginitis?

Answer 2

Epithelial lining of vagina and urinary tract respond to oestrogen by becoming thicker, more elastic and producing secretions

When oestrogen falls, mucosa becomes thinner, less elastic and more dry, tissue more prone to inflammation, also changes in vaginal pH and microbial flora

Question 3

How does atrophic vaginitis present?

Answer 3

Postmenopausal women
- Itching
- Dryness
- Dyspareunia
- Bleeding due to inflammation

Question 4

What is present on examination of atrophic vaginitis?

Answer 4

Pale mucosa
Thin skin
Reduced skin folds
Erythema and inflammation
Dryness
Sparse pubic hair

Question 5

How is atrophic vaginitis managed?

Answer 5

Topical oestrogen
- Creams
- Pessaries
- Tablets
- Rings (replaced every 3 months)

Increases risk of breast cancer, angina and VTE