Postmenopausal atrophic vaginitis

The vaginal and valvular atrophy (atrophic vulvovaginitis) is characterized by the thinning, dryness and inflammation of the vaginal walls that happens when estrogen levels diminish.

The main cause is the start of menopause, although accelerating factors can exist such as: smoking, lactation, radiotherapy, chemotherapy and the absence of sexual activity.

The symptoms are associated with vaginal wall thinning, dryness, fragility and elasticity loss alongside discomfort or vaginal pain that exacerbates during sexual intercourse. The absence of vaginal flux and the presence of possible bleeding after intercourse are of importance. They can be accompanied by urinary symptoms such as itchiness, which is why it is called "Genitourinary syndrome of menopause".  

The diagnosis is clinical, done through questioning and gynecological exploration where dryness and vaginal walls fragility is evidenced. In the cases where urinary symptoms are detected, it might be necessary to do a urinary culture.

The treatment is based on the application of genital moisturizers. If the symptoms are severe, the doctor might recommend estrogen therapy to improve the natural moisture and elasticity of the vagina. Estrogens can be administered topically and/or orally, and their results can be perceived after some weeks of having started the treatment.