Atrophic vaginitis: Symptoms, causes, and treatments

Atrophic vaginitis is a vaginal disorder that usually happens after menopause. When estrogen levels fall, the vaginal walls can become thin, dry, and inflamed. This can be uncomfortable.

Between 10 and 40 percent of women experience symptoms of atrophic vaginitis after menopause, but only 20 to 25 percent will seek medical help.

Others may not do so because they use home treatment or because they feel embarrassed due to the sensitive nature of the condition.

Left untreated, it can affect quality of life.

Fast facts on atrophic vaginitis

Atrophic vaginitis refers to dryness of the vagina.

Around 40 percent of postmenopausal women experience symptoms, but many do not seek treatment.

Symptoms include painful intercourse and an increase in urinary tract infections (UTIs).

It is caused by a reduction in estrogen, normally following menopause or treatment with anti-estrogen drugs.

Topical treatments and hormone replacement therapy (HRT) may held relieve symptoms.


Atrophic vaginitis
Atrophic vaginitis can lead to vaginal dryness and discharge.

Here are the main indicators of atrophic vaginitis:

vaginal dryness

pain during sexual intercourse, or dyspareunia

thin, watery, yellow or gray discharge

paleness and thinning of the labia and vagina

irritation when wearing certain clothes, such as tight jeans, or when on a bike seat

more frequent urinary tract infections (UTIs)

Symptoms also present in the urination process. These include:

painful urination

blood in the urine

increased frequency of urination


increased likelihood and occurrence of infections

There may also be a reduction in public hair, and the vagina may become narrower and less elastic.

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The most common cause of atrophic vaginitis is the decrease in estrogen after menopause. It can also occur after childbirth, and it can happen when anti-estrogen drugs are used to treat other conditions.

The ovaries make estrogen until a woman experiences menopause. In the United States, 51 years is the average age at which menopause occurs. Before menopause, the estrogen in a woman’s bloodstream helps protect the skin of the vagina and stimulates vaginal secretions.

When the ovaries stop making estrogen after menopause, the walls of the vagina become thin, and vaginal secretions are reduced. Similar changes can happen to women after childbirth, but these changes are temporary and less severe.

Medications or hormones can be used as part of the treatment for breast cancer, endometriosis, fibroids, or infertility to reduce estrogen levels. This decrease can lead to atrophic vaginitis.

Other causes include:

treatment to the pelvic area

uncontrolled diabetes


severe stress


rigorous exercise

Atrophic vaginitis may occur in younger women who have had surgery to remove their ovaries. Some women develop the condition at times when estrogen levels are naturally lower, such as during breastfeeding.

Other substances that can cause further irritation to the vagina are soaps, laundry detergents, lotions, perfumes, or douches.

Smoking, tampons, yeast infections, and condoms may also trigger or worsen vaginal dryness.

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