Vaginitis: Atrophic (Genitourinary Syndrome Of Menopause)

Introduction

• Description: Atrophic vaginitis is characterized by the degeneration (atrophy) of vaginal tissues caused by the loss of ovarian steroids. It is part of the broader issue of genitourinary syndrome of menopause.

• Prevalence: Occurs to some extent in 100% of postmenopausal women who do not undergo estrogen therapy.

• Predominant Age: 50 years and older (or after surgical menopause).

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Loss of estrogen stimulation as a result of surgery, chemotherapy (alkylating agents), radiation, natural cessation of ovarian function (menopause), antiestrogenic drugs, or gonadotropin-releasing hormone agonist therapy.

• Risk Factors: Loss of ovarian function because of age, chemotherapy, radiation, or surgery.

Signs and Symptoms

• Vaginal dryness, burning, and itching

• Pain or bleeding with intercourse (may be associated with lacerations)

• Thin, shiny, red epithelium with a smooth surface (loss of rugae)

Diagnostic Approach