Atrophic vaginitis or vaginal atrophy causes the vaginal walls to get thin due to decreased levels of estrogen. This condition usually occurs after one goes through menopause. Women suffering from vaginal atrophy are most likely to face chronic vaginal infections and problems in the urinary function.

Factors causing atrophic vaginitis
The prime factor causing atrophic vaginitis is reduced levels of estrogen. Due to the low estrogen, vaginal tissues become thin and eventually dry up, making the walls more delicate, and in turn easily prone to injury. Vaginal walls lose their natural elasticity too. Sexual intercourse can become painful as a result.

  • Menopause
    In most of the cases, atrophic vaginitis occurs post-menopause. Women between the age group of 45-55 are most likely to suffer from it. Urinary tract infections might occur too.
  • Breastfeeding
    Breastfeeding might lead to reduced estrogen in a woman’s body, especially if she is breastfeeding immediately after the delivery. The decline in estrogen may last as long as lactation is continued. Hence, many women may experience vaginal atrophy in the post-delivery phase.
  • After chemotherapy for treating cancer
    Most of the chemotherapy procedures, which are undertaken to treat various cancers, can cause or exacerbate atrophic vaginitis. A widely used cancer medication called Tamoxifen blocks estrogen, causing VVA (vulvar & vaginal atrophy). Women undergoing high-dose of chemotherapy are more likely to experience long-term vaginal dryness.

Here are a few other factors that cause atrophic vaginitis:

  • Removal of ovaries
  • Pelvic radiation therapy for cancer
  • Hormonal therapy

Diagnosis of atrophic vaginitis:

  • Pelvic exam
    During the pelvic exam, a doctor checks your pelvic organs and examines the external genitalia, cervix, and vagina. Along with that, a test for pelvic organ prolapse is also done. In case a person is suffering from atrophy, these two signs are visible: The introital stenosis’s width will be lesser than two fingers, and there will be a reduced vaginal depth. All these changes are apparent visually.

    If these conditions are not diagnosed early on, the pelvic examination can be painful especially when inserting the speculum. A pelvic examination can also help identify irritation caused by urinary incontinence.

  • Urine and acid balance test
    A urine test is done to collect and analyze it. In addition to that, an acid balance test samples the vaginal fluids and tests its acid content.
  • Lab Findings
    Laboratory diagnostic testing along with serum hormone levels and Papanicolaou smear can help in confirming atrophy. An increased pH level checked with pH strip in the vaginal vault, can confirm atrophic vaginitis. Usually, postmenopausal pH scale beyond 5 is considered as a sign of the condition.

Diagnosing vaginal dryness or irritation as atrophic vaginitis in a postmenopausal patient can be faulty; especially in the case of those who have urogenital complaints. Many times, products like soaps, talcum powders, deodorants, and panty liners include certain compounds, which cause irritation to the vagina.

Wearing tight-fitting clothes and excessive or extended use of sanitary pads or synthetic materials can stimulate atrophic symptoms too. A thorough pelvic examination is needed along with special tests.