Diseases & Conditions

Atrophic Vaginitis

Overview, Causes, & Risk Factors

Atrophic vaginitis is an erosion of the vaginal tissues. This condition usually occurs after a woman has gone through menopause.

What is going on in the body?

Low levels of estrogen cause a loss of lubrication, or moisture, in the vaginal tissues. At the same time, the vagina receives less blood supply and nutrients. And those two changes together can cause the vaginal wall to thin out. Women have low levels of estrogen at certain times of life:

  • before puberty
  • while breast-feeding
  • after menopause, or during postmenopause
  • At these times, the vagina also becomes less acidic. Harmful bacteria may replace the germs that are usually found in the vagina. So the vagina becomes more prone to trauma and infection.

    What are the causes and risks of the condition?

    This condition occurs when the ovaries produce too little estrogen. It is very rare in children. In women who have this condition, infection and trauma during intercourse become more likely.

    Symptoms & Signs

    What are the signs and symptoms of the condition?

    Some women have no symptoms. But many women report symptoms such as:

  • painful sexual intercourse, known as dyspareunia
  • poor lubrication with intercourse
  • some vaginal spotting
  • vaginal dryness
  • vaginal irritation, such as burning or soreness

  • Diagnosis & Tests

    How is the condition diagnosed?

    A doctor will do a pelvic exam to assess the health of the vaginal tissue. He or she can also check vaginal discharge for signs of infection. Typical signs include large numbers of white blood cells and bacteria.

    Prevention & Expectations

    What can be done to prevent the condition?

    Doctors may prescribe hormone replacement therapy, called HRT, to prevent and treat atrophic vaginitis. HRT usually consists of estrogen. A person can take estrogen in several forms:

  • pills
  • skin patches
  • creams, which are applied to the vaginal tissues
  • Some women may benefit from a diet high in foods that contain plant estrogens, known as phytoestrogens. These include soy, flaxseeds, and red clover.

    What are the long-term effects of the condition?

    Long-term effects of this condition include chronic Candida albicans,\ \Candida tropicalis,\ \Candida glabrata,\ and \Candida parapsilosis.\ ',CAPTION,'Vaginal Yeast Infection');" onmouseout="return nd();">vaginal yeast infections. Also common are scrapes and scratches of the vulva and vagina that can cause painful intercourse.

    What are the risks to others?

    Atrophic vaginitis itself is not catching. But, sometimes an infection develops as a result of the condition. And this infection may be passed to a sexual partner during intercourse.

    Treatment & Monitoring

    What are the treatments for the condition?

    HRT is the treatment for low levels of estrogen in a woman's body. Vaginal creams used to treat this condition are usually applied two or three times a week. Estrogen tablets may be given alone if the uterus has been removed. Otherwise, estrogen may be combined with progestin. Skin patches of estrogen may be used instead of pills. The patches only need to be changed once or twice a week, so they can be more convenient to use.

    A woman with this condition can also use these measures to help prevent irritation of the vagina.

  • Moisten the vaginal opening with K-Y jelly or glycerin-based ointments before intercourse.
  • Spend more time on intimacy and foreplay before vaginal penetration.
  • Avoid chemical irritants such as spermicides, douches, bubble baths, and deodorant sprays.
  • Use gentle soaps for bathing.
  • Wipe from front to back after urinating or having a bowel movement.
  • If there is vaginal bleeding, use unscented sanitary napkins instead of tampons.
  • Avoid tight pantyhose or nylon underwear.
  • What are the side effects of the treatments?

    Estrogen creams can cause vaginal spotting. The cream itself may also be irritating. Estrogen pills and patches may cause the following side effects:

  • abdominal bloating and cramping
  • breast tenderness
  • nausea
  • vaginal spotting or bleeding
  • These side effects generally go away within a month or so after starting HRT, as the body adjusts.

    What happens after treatment for the condition?

    Without treatment, this condition and its symptoms will not go away. With treatment, symptoms will improve for as long as the treatment lasts. Normal vaginal moisture usually returns after 2 to 4 weeks of vaginal cream therapy.

    How is the condition monitored?

    Once treatment has eliminated the symptoms, be sure to make follow-up visits to the doctor. At least once a year, the doctor should do a pelvic examination and physical. Report any new or worsening symptoms to the doctor.


    Author:Eva Martin, MD
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:02/11/02
    Reviewer:Eileen McLaughlin, RN, BSN
    Date Reviewed:02/11/02


    Maternity and Gynecological Care, The Nurse and the Family, Bobak et al., 1989.