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Postmenopausal (Senile/Atrophic) Vaginitis

WHAT IS POSTMENOPAUSAL VAGINITIS?

A suffix of 'itis' means inflammation of the part to which 'itis' is added. Here it means inflammation of the vagina. Vaginitis found in women after they have attained Menopause. This is caused by lowered estrogen levels that upset the vagina's normal hormone and pH balance. Unlike other forms of vaginitis, Post-menopausal vaginitis is not contagious through sexual intercourse.

SIGNS & SYMPTOMS

Severity of the symptoms varies greatly between individual women and from time to time in the same woman.

  • Foul-smelling vaginal discharge, which is usually thin, whitish and sometimes tinged with blood.
  • Pain and itching around the vulva.
  • Discomfort or pain during sexual intercourse.
  • Change in vaginal mucosa from pale-pink to red.

CAUSES

Certain bacteria normally inhabit the vagina. These cause infection when the normal physiology of the vagina is disturbed. After menopause, the estrogen level that helped maintain a normal vaginal environment decreases, leaving the vagina more vulnerable to infection. The following conditions increase the likelihood of post-menopausal vaginitis

  • General poor health.
  • Hot weather, non-ventilating clothing--especially underwear--or any other condition that increases genital moisture, warmth and darkness, that foster the growth of germs.

RISK INCREASES WITH

  • Diabetes.
  • Illness that has lowered resistance.
  • More frequent sexual intercourse.

HOW TO PREVENT

  • Keep the genital area clean. Use plain unscented soap.
  • Wear cotton panties. Avoid panties made from non-ventilating materials, such as nylon.
  • Don't sit around in wet clothing.
  • After urination or stools, cleanse by wiping or washing from front to back (vagina to anus) to prevent bacteria from anus entering vagina.
  • Lose weight if overweight.
  • If you have diabetes, adhere strictly to your treatment program and ensure normal blood sugar levels.
  • Ask your doctor about Hormone Replacement Therapy.

DIAGNOSTIC MEASURES

  • Typical symptoms
  • History and clinical examination (including pelvic exam) by a doctor.
  • Laboratory studies, such as a Pap smear, and microscopic exam and culture of the vaginal discharge.

POSSIBLE COMPLICATIONS

Secondary bacterial infection in any pelvic organ.

PROBABLE OUTCOME

Usually curable in 10 days with treatment.

TREATMENT

GENERAL MEASURES

  • Follow the first 4 instructions under How to Prevent.
  • If urinating causes burning:
    • Urinate through a tubular device, such as a toilet-paper roll or plastic cup with the end cut out.
    • Urinate while bathing.

MEDICATION

You may be prescribed:

  • Topical or oral estrogen. If you use a cream or suppository, use a small sanitary pad to protect clothing. Keep creams or suppositories in the refrigerator. After treatment, ask your doctor whether you can begin treatment quickly if the infection recurs.
  • Other creams, ointments or suppositories to suppress the organisms causing the infection.

ACTIVITY

Avoid overexertion, heat and excessive sweating. Delay sexual relations until you are well. Use lubricating jelly.

DIET

No special diet.

CONTACT YOUR DOCTOR IMMEDIATELY, IF

  • You are menopausal and notice symptoms of vaginitis.
  • Symptoms persist longer than 1 week or worsen, despite treatment.
  • Unusual vaginal bleeding or swelling develops.
  • After treatment, symptoms recur.
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