What is vaginal atrophy?

Vaginal atrophy (also called atrophic vaginitis) is a condition where the lining of the vagina gets drier and thinner. This results in itching, burning and pain during sex, among other symptoms. The condition also includes urinary tract problems such as urinary tract infections (UTIs) and frequent urination. Vaginal refers to the vagina while atrophy means “a wasting away or diminution.” Recently, the term vaginal atrophy has been replaced with the newer term, genitourinary syndrome of menopause (GSM). This new term helps describe not just the vaginal, but also the urinary symptoms that can be accompanied by the effects of low estrogen.

Vaginal atrophy most often occurs during menopause, the “change of life.” This happens because of a decrease in the hormone estrogen. It can occur in younger women, as well, when their estrogen levels are affected.

Hormones are produced, stored and secreted by the endocrine system, a network of glands and organs. Women need the hormone estrogen for good health, especially during the child-bearing years. When menopause happens around age 50, the ovaries produce fewer hormones and the woman stops having a monthly period. There are many uncomfortable symptoms for women during that time, and that includes vaginal dryness and other symptoms that might indicate vaginal atrophy.

What’s the difference between vaginal atrophy (atrophic vaginitis) and a yeast infection?

Both vaginal atrophy and yeast infections can have symptoms of dryness, itching, redness and pain. However, vaginal atrophy is caused by a lack of estrogen while a vaginal yeast infection is caused by a fungal infection. Consult with your healthcare provider regarding symptoms so that you, together, can determine what condition you have.

Who is at risk for getting vaginal atrophy (atrophic vaginitis)?

Women age 50 and over, in menopause, are the most likely to experience vaginal atrophy. Other factors that increase your likelihood of developing vaginal atrophy include:

  • Lack of sexual intercourse.
  • Decreased ovarian functioning due to chemotherapy or radiation.
  • Immune disorders.
  • Medications that contain antiestrogen properties including Tamoxifen (Nolvadex), Medroxyprogesterone (Provera) and Nafarelin (Synarel).
  • Nonfluctuating estrogen levels.
  • Oophorectomy (removal of the ovaries).
  • Postpartum loss of placental estrogen.
  • Smoking.
  • Breastfeeding.

How common is vaginal atrophy (atrophic vaginitis, GSM)?

At least half of women who enter menopause suffer from signs and symptoms of genitourinary syndrome of menopause.

What causes vaginal atrophy (atrophic vaginitis)?

During menopause, your body makes less estrogen. Without estrogen, the lining of the vagina can become thinner and less stretchy. The vaginal canal can also narrow and shorten. Less estrogen lowers the amount of normal vaginal fluids. It also changes the acid balance of the vagina. Women who have just had a baby and are breastfeeding also have a drop in estrogen. These symptoms also occur in women who have had their ovaries removed or are taking certain medications (such as aromatase inhibitors for breast cancer treatment).

The first sign of vaginal atrophy is usually a decrease in vaginal lubrication.

What are the symptoms of vaginal atrophy (atrophic vaginitis)?

Symptoms of vaginal atrophy can include:

  • Dryness of the vagina.
  • Burning and/or itching of the vagina.
  • Dyspareunia (pain during sex).
  • A discharge from the vagina – usually a yellow color.
  • Spotting or bleeding.
  • Vulvar itching (pruritus).
  • Feeling of pressure.

It can also affect your urinary system and cause symptoms. These include:

  • Going to the bathroom often.
  • Having pain when going to the bathroom.
  • Urinary tract infections (UTIs).
  • Urinating more.
  • Stress incontinence.
  • Painful urination (dysuria).
  • Blood in the urine (hematuria).
  • Burning during urination.

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