VAGINAL ATROPHY - Overview, Facts, Types, Symptoms, Diagnosis


Vaginal atrophy is the inflammation, drying, and thinning of the vaginal walls when the body has less estrogen. Also, this can mostly transpire after menopause

For some women, vaginal atrophy does not only make sexual intercourse painful, yet it also leads to upsetting urinary symptoms. Since the condition causes both urinary symptoms and vaginal atrophy, doctors use the word “genitourinary syndrome of menopause” to specify vaginal atrophy and its correlated symptoms. 

GSM or genitourinary syndrome of menopause is due to the dropping of estrogen production. Fewer estrogen can make your vaginal tissues drier, thinner, less elastic, and more fragile. Also, a decrease in estrogen levels may transpire after chemotherapy, during breastfeeding, after pelvic radiation therapy, and after taking medications that influence estrogen levels. 


The most common signs and symptoms of vaginal atrophy include:

  • Genital itching
  • Vaginal burning
  • Vaginal dryness
  • Urgency with rumination
  • Vaginal discharge
  • Urinary incontinence
  • Frequent urination
  • Tightening and shortening of the vaginal canal
  • Discomfort with intercourse
  • Recurrent UTI
  • Decreased vagina lubrication during intercourse
  • Light bleeding after sexual activity

Make an appointment with your ob-gyne if you experience unexplained vaginal bleeding, spotting, soreness, burning, and unusual discharge.


To diagnose vaginal atrophy, the doctor will ask you about your symptoms and medical history, and execute the following exams:

  • Urine test, which includes testing and collecting your urine, if you have any urinary symptoms
  • Acid balance test, which provides for taking a sample of your vaginal fluid to test its acid balance
  • Pelvic exam, in order to examine your external vagina, cervix, and genitalia

It is important to tell all your symptoms to your doctor so that he/she can diagnose and treat them appropriately.


To treat vaginal atrophy, the doctor might first suggest OTC medications, such as:

  • Water-based lubricants
  • Vaginal moisturizers

If these OTC don’t help with your symptoms, the doctor might prescribe:

  • Topical estrogen, such as vaginal estrogen cream, vaginal estrogen tablet, and vaginal estrogen ring
  • Ospemifene
  • Prasterone
  • Systemic estrogen therapy
  • Vaginal dilators
  • Topical lidocaine 

Furthermore, if you have breast cancer or a history of cancer, tell your healthcare provider and consider these choices:

  • Vaginal estrogen
  • Vaginal dilators
  • Non-hormonal treatments 
  • Systemic estrogen therapy

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