Estrogen is responsible for the normal functioning of several tissues that keep the vagina lubricated and healthy. However, a decrease in estrogen levels (common in menopausal women and lactating mothers) results in dryness and inflammation of the vagina as well as the vulva. This condition is called atrophic vaginitis.
A woman suffering from atrophic vaginitis experiences symptoms such as itchiness and burning sensation in the vagina, slight vaginal discharge that may be yellowish in color, pain during and after sexual intercourse (sometimes accompanied with light bleeding), and painful urination.
Medications for atrophic vaginitis include hormonal or nonhormonal treatments. Learn more about the benefits, side effects and possible risks of each type of treatment.
According to Dr. George Gorodeski, Professor of Reproductive Biology, Oncology, and Physiology and Biophysics in Case Western University at Ohio, Estrogenic Treatment (ET) is considered as the most effective treatment for symptomatic relief of atrophic vaginitis. He enumerated several benefits that patients can get from this mode of treatment such as the following:
- Reversal of vaginal atrophy (to a certain extent)
- Promotion of growth and development of the cells in the vagina
- Enhancement of blood flow to the vaginal tissue
- A decrease in the pH levels, due to the direct effect of estrogen treatment to the vaginal epithelial cells
Hormonal Therapy may be progesterone and estrogen treatment or estrogen treatment only. Systemic Hormone Treatment is administered in several routes (oral, vaginal, transdermal) and is effective in improving vaginal symptoms of atrophic vaginitis. But the more potent ones for alleviating vaginitis symptoms are vaginal preparations such as the vaginal ring. This medication is US FDA-approved, and it contains 17 beta-estradiol (may be obtained in 50 or 100 mcg) that is recommended to be used every three months. Vaginal preparations are effective not only in treating vaginitis, but they also prevent bone loss and have a positive effect on the vaginal tissues.
Dr. Gorodeski advised that in using this type of treatment, patients must be given the lowest dose of estrogen at the shortest possible duration. Prolonged use of hormone treatment increases the risk of breast cancer, cardiovascular disease (if treatment has begun in women aged 60 or older), endometrial hyperplasia and cancer (for patients with uterus).
Vaginal Estrogen Treatment is also effective in treating symptoms of atrophic vaginitis, but this mode of treatment takes longer than systemic ET because Vaginal ET has a smaller dose, that is increased during the course of long-term treatment. Among the brand names available that are FDA-approved are Premarin (Wyeth) and Estrace (Warner PPD). Reduction of “bad” cholesterol levels in the body and improvement of bone density are among the benefits of Vaginal ET; however vaginal discharge or leucorrhea is a common side effect.
The use of moisturizers and lubricants may be effective as well in alleviating vaginitis symptoms. Replens is a vaginal moisturizer that is commonly recommended by doctors, because of its approved efficacy in improving vaginal symptoms. There are other brand names of vaginal moisturizer that may be effective, but these were not tested yet for randomized trials.
Petroleum jelly, hand creams and baby oil are not advisable as treatment for vaginitis symptoms as these can irritate the vagina and may even increase the risk of vaginal infection.
Vaginal symptoms of atrophic vaginitis may be mild or serious, and either way, this condition can cause physical discomfort in women. Several medications for atrophic vaginitis are available, and consultation to a health care provider will determine the best treatment option appropriate for the patient.
Atrophic Vaginitis and Estrogen Treatment, https://www.medscape.org/viewarticle/560168
Atrophic Vaginitis, https://www.nlm.nih.gov/medlineplus/ency/article/000892.htm