Atrophic Vaginitis

Introduction

You may be experiencing some noticeable problems or skin changes around your genital area, or skin changes to your vagina, cervix and genital skin may have been observed during your recent examination in clinic – these changes may be caused by “Atrophic Vaginitis.”

What is Atrophic Vaginitis?

Atrophic vaginitis is a condition that mostly occurs after the menopause, when the lack of the female hormone, oestrogen, causes changes to the skin of the vagina and genital area.

The vagina is kept healthy and moist by fluids and mucous which are made by the glands at the neck of the womb.

The reduction of oestrogen affects these glands and the tissues in and around the vagina.

After the menopause the ovaries make less oestrogen. The lack of oestrogen leads to a thinning of the tissues around the vaginal area, and the number of small glands that make mucus reduces.

You may also lose some fat tissue from around the genital area. This can cause the vulva and vagina to look slightly different than before the menopause.

How common is it?

Vaginal dryness occurs in about 1 in 4 women leading up to the menopause, it becomes more common after the menopause when about 1 in 2 women are affected.

About 7 in 10 women in their seventies have this problem.

What symptoms can occur?

• Painful intercourse – the skin of the vagina becomes drier and less likely to become lubricated during sex, this can cause pain.

• Vaginal bleeding – as the skin becomes thinner and more fragile this can lead to spotting and bleeding. Any post-menopausal bleeding must always be reported to your GP.

• Infection and discharge – an atrophic vagina is more likely to develop infection causing an offensive smelling discharge and may need antibiotic treatment.

• Discomfort and/or itching of the vulva and vagina – some women experience itching which produces a tendency to scratch, this is more likely to make the skin itch and can develop the “itch/scratch cycle,” this in turn can be distressing.

• Urinary problems due to thinning of the skin around the neck of the bladder, or urethra – passing water too often (frequency) and/or not being able to hold on (urgency). Atrophy tends to aggravate any prolapse of part of the vaginal wall, and this may also cause urinary problems.

What are the treatments for Urogenital Atrophy?

Not all women have all of the above symptoms. Treatment may depend on which symptoms are the most troublesome.

Because the problem is mainly due to a lack of oestrogen it can be helped by replacing the oestrogen topically (absorbing into the skin).

This can be done in several ways:

• Oestrogen creams or Vaginal Pessary – sometimes a cream or pessary containing oestrogen is prescribed. This replaces oestrogen to the vagina and surrounding tissues, usually the cream or pessary is used every night for 2 weeks and then twice a week for a further 4 weeks. This treatment is usually effective and can be repeated if the problem recurs. If hormone creams can’t be used because of other medical conditions, gels such as Yes, Replens, Regelle or Sylk can be purchased from the local pharmacy or with a prescription from your GP. You can also buy these online and ask for free samples.

• Hormone Replacement Therapy (HRT) – this means taking hormone drugs in the form of a tablet, gel, implant or patches. This may be the best treatment, but some women don’t like the idea that periods may return with this treatment, especially if it is many years since the menopause. You can discuss this more fully with your GP.

• Non-hormonal Lubricants – these are used with sex if dryness is a problem. Most post-menopausal women will require a ‘lube’ with sex. Many preparations are available over the counter and your GP can also prescribe. Again, these are available on-line.

Further Advice

We hope that you have found the information in this leaflet helpful. If you require any further advice regarding your care, please do not hesitate to ask the clinic staff. They are there to support you and are happy to help with any concerns or anxieties you may have.

Contact numbers

University Hospital of North Tees

Outpatients Department:
Monday to Friday, 09.00am to 5.00pm
Telephone 01642 624172

University Hospital of Hartlepool

Outpatients Department:
Monday to Friday, 09.00am to 5.00pm
Telephone 01429 522865

You can also contact a Specialist Nurse Colposcopist on the following number
Colposcopy Hub:
Monday to Friday, 8.30am to 4.30pm
Telephone 01429 522268

Useful web sites for non-hormonal Lubricants:

https://www.yesyesyes.org
https://sylk.co.uk
https://www.regelle.co.uk
https://www.replens.com

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Team is here to try to resolve your concerns. The office is based at the University Hospital of North Tees if you wish to discuss concerns in person. Our contact details are:

Telephone: 01642 624719
Freephone: 0800 092 0084
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Telephone: 01642 617617

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