Atrophic Vaginitis

Question 1

Define Atrophic vaginitis.

Answer 1

Vaginal irritation caused by thinning of the vaginal epithelium.

Question 2

What are the risk factors for atrophic vaginitis?

Answer 2

• Menopause
• Prolonged lactation

Question 3

What are the signs and symptoms of atrophic vaginitis?

Answer 3

• Vaginal irritation
• Dyspareunia
• Superficial dysuria
• Discharge – may be bloody
• O/E: pale, thin vaginal walls with loss of rugal folds, cracks or fissures

Question 4

What are the appropriate investigations for atrophic vaginitis?

Answer 4

• Clinical
• Swabs for any potential infection
• Biopsy for any potential malignancy or ulcers

Question 5

What is the management for suspected atrophic vaginitis?

Answer 5

• Depends on complaint:
  
  • Systemic HRT (systemic progesterone + PV oestrogen)
  • Bleeding on intercourse → water-based moisturisers and lubricants

Question 6

What are the complications of atrophic vaginitis?

Answer 6

• Increased incidence of superinfection due to increase vaginal pH
• Prognosis – substantial relief can be achieved with treatment