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Atrophic vaginitis is an inflammation of the vagina due to thinning and shrinking tissues and a decrease in lubrication.

Atrophic vaginitis is typically caused by a decrease in estrogen. Estrogen levels normally drop after menopause. The disorder may occur in younger women who have had surgery to remove their ovaries. Some women develop the condition immediately after childbirth or while breastfeeding, since estrogen levels are lower at these times.

• Burning on urination
• Light bleeding after intercourse
• Painful sexual intercourse
• Slight vaginal discharge
• Vaginal soreness -- itching or burning sensation

A pelvic examination reveals thin, pale vaginal walls. A wet prep test of vaginal discharge may be done to rule out other causes for the condition. Hormonal studies may be done to determine if you are in menopause.

Estrogen replacement therapy may be recommended. Estrogen may be given as a cream, tablet, or ring placed into the vagina, as a skin patch, or in a pill that you take by mouth.

Women may want to discuss the risks and benefits of estrogen replacement therapy with their health care provider.

A water-soluble vaginal lubricant may help relieve pain during intercourse.

Proper treatment will usually relieve the symptoms.

Atrophic vaginitis may make you more prone to vaginal infections caused by bacteria or fungi (yeast).

Atrophic vaginitis can also cause open sores or cracks in the vaginal wall.

Call for an appointment with your health care provider if you are experiencing vaginal dryness or soreness, burning, itching, or painful sexual intercourse that is not alleviated with a water-soluble lubricant.

Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, HIV infections. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 22.

Lobo RA. Menopause: endocrinology, consequences of estrogen deficiency, effects of hormone replacement therapy, treatment regimens. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 42.

Updated by: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington ; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.