Atrophic vaginitis

From Wikipedia, the free encyclopedia

Atrophic vaginitis (also known as vaginal atrophy) is an inflammation of the vagina due to thinning and shrinking tissues and decreased lubrication of the vaginal walls. It is caused by a lack of estrogen. The most common cause is the decrease in estrogen after the menopause although it can be caused by other conditions. Symptoms include vaginal soreness and itching, as well as painful intercourse, and bleeding after sexual intercourse.

Contents 1 Symptoms and signs 2 Incidence and causes 3 Diagnosis 4 Treatment 4.1 Boxed Warning 5 Prognosis 6 Prevention 7 Notes 8 References

[edit] Symptoms and signs

Genital: dryness, itching, burning, soreness, pressure, thick yellow white discharge, malodorous discharge, infection, painful sexual intercourse, bleeding after intercourse. In addition, sores or cracks may occur.

Urinary: painful urination, blood in the urine, frequency, incontinence, and infection.

[edit] Incidence and causes

An estimated 10 to 40 percent of postmenopausal women have symptoms of atrophic vaginitis, however only 20 to 25 percent seek medical attention.

The cause is a decrease in estrogen normally as a result of menopause. Other causes of decreased estrogen are decreased ovarian functioning due to radition theraphy or chemotheraphy, immune disorder, removal of the ovaries, after pregnancy, during lactation, idiopathic, and various medications (Tamoxifen (Nolvadex), Danazol (Danocrine), Medroxyprogesterone (Provera), Leuprolide (Lupron), Nafarelin (Synarel)).

In addition, it may be caused by lack of sexual activity.

[edit] Diagnosis

It is important to see your physician.

[edit] Treatment

Topical estrogen creams or tablets may be used vaginally. Oral or transdermal estrogen may be used. See Boxed Warning about estrogen theraphy below.

Sexual activity is also helpful. A water-soluble vaginal lubricant may be useful.

[edit] Boxed Warning

The labeling of estrogen-only products includes a boxed warning that unopposed estrogen (without progestin) therapy increases the risk of endometrial cancer.

Based on a review of data from the WHI, on January 8, 2003 the FDA changed the labeling of all estrogen and estrogen with progestin products for use by postmenopausal women to include a new boxed warning about cardiovascular and other risks. The estrogen-alone substudy of the WHI reported an increased risk of stroke and deep vein thrombosis (DVT) in postmenopausal women 50 years of age or older and an increased risk of dementia in postmenopausal women 65 years of age or older using 0.625 mg of Premarin conjugated equine estrogens (CEE). The estrogen-plus-progestin substudy of the WHI reported an increased risk of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli and DVT in postmenopausal women 50 years of age or older and an increased risk of dementia in postmenopausal women 65 years of age or older using 0.625 mg of CEE with 2.5 mg of the progestin medroxyprogesterone acetate (MPA).^[1][2][3]

[edit] Prognosis

Proper treatment will usually relieve the symptoms.

[edit] Prevention

Regular sexual activity. A water soluble vaginal lubricant can be helpful.

[edit] Notes

1. ^ FDA (1-8-2003). FDA Approves New Labels for Estrogen and Estrogen with Progestin Therapies for Postmenopausal Women Following Review of Women's Health Initiative Data. Retrieved on 2006-09-20.
2. ^ IMPORTANT WARNING. MedlinePlus. Retrieved on 9-18-2006.
3. ^ Kolata, Gina (1-9-2003). F.D.A. Orders Warning on All Estrogen Labels. The New York Times. Retrieved on 9-18-2006.

[edit] References

Bachmann M.D., Gloria (5-15-2000). Diagnosis and Treatment of Atrophic Vaginitis. American Academy of Family Physicians. Retrieved on 9-18-2006.

Atrophic vaginitis. MedlinePlus (10-25-2004). Retrieved on 9-18-2006.

Vaginal Atrophy (Atrophic Vaginitis) (2-3-2006). Retrieved on 9-18-2006.