Edit concept Question Editor Create issue ticket

Vaginal Atrophy


Presentation

  • Women affected by this condition may present a variety of symptoms including vaginal and vulvar pain and irritation.[ncbi.nlm.nih.gov]
  • Prolapse, which may have been present since childbirth, can become symptomatic as the mucosa becomes less elastic and the pelvic floor loses tone.[journals.sagepub.com]
  • If other health problems are also present, these can be taken into account when determining the best course of treatment.[en.wikipedia.org]
  • In a cohort of breast cancer survivors, vaginal dryness was present in 23.4% of the premenopausal patients and in 61.5% of the postmenopausal patients. 8 PHYSIOLOGY Vulvovaginal atrophy occurs under conditions of hypoestrogenism.[ncbi.nlm.nih.gov]
Asymptomatic
  • However, in some women with mild-to-moderate severity, VVA occurs asymptomatically and verification of diagnosis is possible only with vaginal examination. 16 The diagnosis of VVA is made difficult by the low awareness of women about the pathological[ncbi.nlm.nih.gov]
Weakness
  • Ospemifene has relatively weak estrogenic and antiestrogenic effects in classical hormonal tests, has an anti-osteoporosis effect, and reduces the level of total cholesterol.[ncbi.nlm.nih.gov]
Ulcer
  • Marked painless vulval edema may occur Acute vulvar ulcers or Lipschütz ulcers Acute painful genital ulcerations of the vulva or lower vagina.[ncbi.nlm.nih.gov]
  • […] chronicus, may cause similar symptoms. 21 Cancer and precancerous lesions, including vulvar intraepithelial neoplasm, vulvar cancer, and extramammary Paget disease, are in the differential diagnosis of any localized areas of redness, thickening, or ulceration[ncbi.nlm.nih.gov]
Blister
  • Table 1 Differential diagnosis of VVA Condition Main symptoms and signs Vaginal infections Vaginal discharge (leukorrhea, xanthorrhea), pruritus, bad smell Allergic reactions Redness, swelling, pruritus, occasionally blistering, and pain Lichen planus[ncbi.nlm.nih.gov]
Decreased Libido
  • Women undergoing menopause often experience a number of symptoms including vaginal dryness, itching, painful intercourse, poor lubrication, decreased libido and poor vaginal muscle elasticity and tone.[juliet-laser.com]
Vulvar Pain
  • Women affected by this condition may present a variety of symptoms including vaginal and vulvar pain and irritation.[ncbi.nlm.nih.gov]
Microscopic Hematuria
  • Urinalysis may show microscopic hematuria. Recurrent urinary tract infections can also result.[ncbi.nlm.nih.gov]

Workup

Candida
  • The 3 most common vaginal infections are Candida vulvovaginitis, bacterial vaginosis, and trichomoniasis. Bacterial vaginosis may result from atrophic changes in the vagina.[ncbi.nlm.nih.gov]

Treatment

  • Non-Prescription Treatments Some women find that non-prescription treatments work well, especially for mild symptoms. Non-prescription treatments are hormone-free and have few side effects.[academic.oup.com]
  • This action continues its beneficial effect even after the treatment is finished and, for this reason, many women report further improvements during the first month post-treatment. Back to Treatments Overview[juliet-laser.com]
  • What are the treatment options? For many woman, non-prescription (over-the-counter) treatments can help, especially if symptoms are mild.[hormone.org]
  • Differential Diagnosis for Symptoms of Vulvovaginal Atrophy TREATMENT Nonhormonal Treatments Current over-the-counter treatments include nonhormonal vaginal moisturizers for VVA symptoms and lubricants for dyspareunia.[ncbi.nlm.nih.gov]
  • Treatments First-line treatment for minimal symptoms can be over-the-counter treatments including lubricants, pH-balancing gels and vaginal remoisturizers.[journals.sagepub.com]

Etiology

  • However, the etiology of urogenital disorders related to estrogen deficiency may be forgotten given the time scale that they can take to develop.[journals.sagepub.com]
  • Genitourinary syndrome of menopause: anoverview of clinical manifestations, pathophysiology, etiology, evaluation, andmanagement. Am J Obstet Gynecol. 2016; 215 (6):704–711. [ PubMed ] [ Google Scholar ] 16.[ncbi.nlm.nih.gov]

Epidemiology

  • Recently, the European Vulvovaginal Epidemiological Survey was carried out, in which 2,000 postmenopausal women were examined. Symptoms of VVA were detected in 90% of women.[ncbi.nlm.nih.gov]
  • Women and their partners have reported that estrogen therapy resulted in less painful sex, more satisfaction with sex, and an improvement in their sex life. [1] Epidemiology [ edit ] Up to 50% of postmenopausal women have at least some degree of vaginal[en.wikipedia.org]
  • The trigone of the bladder is also of endodermal origin, and the physical changes correspond with the epidemiological increase in bladder symptoms and cystitis.[journals.sagepub.com]
Sex distribution
Age distribution

Pathophysiology

  • Genitourinary syndrome of menopause: anoverview of clinical manifestations, pathophysiology, etiology, evaluation, andmanagement. Am J Obstet Gynecol. 2016; 215 (6):704–711. [ PubMed ] [ Google Scholar ] 16.[ncbi.nlm.nih.gov]

Prevention

  • For other indications, such as prevention of osteoporosis, sponsors are asked to direct inquiries to the appropriate CDER Office of New Drugs review division.[fda.gov]
  • Prevention of bone loss in postmenopausal women treated with lasofoxifene compared with raloxifene. Menopause. 2006; 13 (3):377–386. [ PubMed ] [ Google Scholar ] 43. Cummings S, Eastell R, Ensrud K.[ncbi.nlm.nih.gov]
  • Oestrogens for treatment or prevention of pelvic organ prolapse in postmenopausal women. Cochrane Database Syst. Rev. 9, CD007063 ( 2010 ). Google Scholar 53. Bateson, DJ, Weisberg, E.[journals.sagepub.com]
  • Limiting or avoiding estrogen can help prevent a return of breast cancer. What should you do if you have symptoms of vaginal atrophy? See your doctor. Your doctor can find the cause of your symptoms and suggest options to help you feel better.[academic.oup.com]
  • Recommendations for the use of the lowest effective dose for the shortest duration help to prevent adverse endometrial effects. [9] Some treatments have been developed more recently.[en.wikipedia.org]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!