What Causes Atrophic Vaginitis & How Is It Treated?

What is Atrophic Vaginitis?

Atrophic Vaginitis refers to a pathological condition of the female external genitalia which is usually seen in menopausal females when the levels of estrogen start to fall. Atrophic Vaginitis is characterized by various structural and physiological changes occurring in the vaginal mucosa. It will cause excessive dryness of the vagina, itching around the vagina and the vulva, painful sexual intercourse, and most of all recurrent urinary tract infections. At times, the affected female also tends to have abnormal vaginal discharge. The most effective treatment thus far for Atrophic Vaginitis is believed to be hormonal therapy to supplement the depleted estrogen levels which almost always reverses the changes that occur due to the low levels of this hormone.[1]

Additionally, there are several moisturizers available which can help with the excessive vaginal dryness and aid in the female having sexual intercourse without any discomfort. In addition to the symptoms mentioned above, a female with Atrophic Vaginitis will also observe thinning of the vagina. The entire genital area will get irritated when wearing tight clothing or when sitting for long periods of time. The female will find it very painful during urination.[1]

In some cases, she might also complain of hematuria and increased urinary frequency. Such females are also prone to frequent infections around the genital area. The elasticity of the vagina also gets affected as a result of Atrophic Vaginitis. This article gives an in-depth analysis of the cause and treatment options for Atrophic Vaginitis.[2]

What Causes Atrophic Vaginitis?

As stated, Atrophic Vaginitis is primarily caused due to a depletion of the estrogen levels in the body. This is usually seen in females who have reached their menopause. In some cases, the levels of this hormone also decrease after the delivery of a child or if a female is given certain medications that decrease the level of this hormone.

Estrogen is produced by the ovaries till the time the female is menstruating.[2]

This hormone is extremely crucial for the development reproductive and sexual functions in a female. This is the reason why they are also referred to as sex hormones. When a girl attains puberty it is the estrogen that causes the development of breasts, pubic hair, and hairs in the armpit in the female. They also play an important role in regulating the menstrual cycle of a female.[3]

Estrogen does so by controlling the growth of the lining of the uterus during the first part of the cycle. If the egg released by the ovary does not get fertilized then the female starts to have her periods. The estrogen levels generally start to dip in the middle age and by the time the female reaches menopause it declines further. Once the ovaries stop producing estrogen after menopause, the vagina loses its natural lubrication and starts to become pale.[3]

This can also be seen after the delivery of a child even though it is a temporary phase. This excessive vaginal dryness is the primary symptom of Atrophic Vaginitis. Some of the other causes of Atrophic Vaginitis include previous history of medical conditions in the pelvic region with treatment. People who have uncontrolled diabetes also tend to develop Atrophic Vaginitis at some point in the future. People who have been treated with chemotherapy for some form of cancer also develop Atrophic Vaginitis. In some cases, certain psychosocial issues like excessive stress or depression also can lead to a female having Atrophic Vaginitis.[2]

There are cases where females of a reproductive age also tend to have Atrophic Vaginitis if they undergo surgery to remove the ovaries for some reason. Females who are breast-feeding their baby also tend to have low levels of estrogen causing Atrophic Vaginitis. Certain chemical irritants like soaps, lotions, or moisturizers also at times can lead to a female developing Atrophic Vaginitis. A female can also have vaginal dryness by excessive use of condoms, history of yeast infections, and who smokes.[2]

How is Atrophic Vaginitis Treated?

Coming to the treatment options for Atrophic Vaginitis, using a lubricant can often help with the dryness of the vagina in a female with Atrophic Vaginitis. This will help in keeping the vagina moist during sexual intercourse. This can be quite effective in mild cases of Atrophic Vaginitis. The frontline treatment however for Atrophic Vaginitis is hormone replacement therapy with supplementation of estrogen. This is given in the form of a gel, tablet, or a patch.[2]

Even though this therapy is perhaps the best, it also has significant side effect profile with chronic use. Thus, a consultation with the physician about the risks and benefits of hormone replacement therapy should be done before embarking on this form of treatment. In some cases, hormone replacement therapy is given only to the affected area, in this case the vagina. For this, an estradiol cream is quite effective in increasing the estrogen levels and lubricating the vagina. Physicians also at times place pessaries and rings within the vagina for treatment of vaginal dryness as a result of Atrophic Vaginitis.[2]

For females with Atrophic Vaginitis, it is essential that they indulge in regular exercise routine diligently to improve the blood flow to the vaginal area. Eating a well-balanced and healthy diet is also quite effective in treating Atrophic Vaginitis, especially incorporating linseeds and fish oils.[2]

In conclusion, Atrophic Vaginitis is a condition of the external female genitalia generally seen in menopausal females which is mainly characterized by vaginal dryness and certain other structural changes like paleness and thinning of the vagina. This is mainly caused due to a decline in the levels of the estrogen which is a common finding in menopausal females. The levels of the estrogen also decline after delivery of a child. Female who smoke, have a history of infections, or indulge in sexual intercourse by using condoms are at an increased risk for developing Atrophic Vaginitis.[1,2]

The frontline treatment for Atrophic Vaginitis is hormone replacement therapy to replenish the levels of estrogen in the body. This is done by way of patch, tablet, or patch. However, this therapy has a significant side effect profile and hence consultation with a physician is a must before starting it. Additionally, for mild cases using a lubricant in the form of moisturizers can help take care of the vaginal dryness and aid in sexual activity for females with Atrophic Vaginitis.[2]

Regular sexual activity also keeps the vagina supple and flexible and in a way delays the progression of Atrophic Vaginitis. Studies have shown that females who are sexually active tend to have very few symptoms of Atrophic Vaginitis, if any. Additionally, eating a balanced diet, exercising regularly, and keeping the genitals clean and dry to prevent infections all play a part in preventing Atrophic Vaginitis and thus should be a part of the daily activity for every female who is nearing menopause or has attained menopause.[2]

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