Senile Vaginitis

What is senile vaginitis?

Senile or atrophic vaginitis is an inflammation or irritation of the vagina caused by thinning and shrinking of the tissues of the vagina and decreased lubrication of the vaginal walls. This is due to a lack of oestrogen. This condition is common in post menopausal women.

What is the cause?

Senile vaginitis is typically caused by a decrease in oestrogen, as normally occurs after menopause. The disorder may occur in younger women who have had surgery to remove their ovaries. Some women experience it immediately after childbirth or while breastfeeding, since oestrogen levels are lower at these times.

The factors that increase the risk include:

• Menopause
  
• Decreased ovarian functioning
  
• Radiation therapy
  
• Chemotherapy
  
• Immune disorder
  
• Elevated prolactin level during lactation
  
• Medications containing anti oestrogen properties
  
• Natural oestrogen deficiency before menopause
  
• Smoking

What are the symptoms?

Senile vaginitis is characterised by:

• Vaginal soreness - an itching or burning sensation.
  
• Slight vaginal discharge.
  
• Burning on urination.
  
• Light bleeding after intercourse.
  
• Painful sexual intercourse

How is it diagnosed?

A pelvic examination reveals thin, pale vaginal walls. A wet preparation (microscopic evaluation of the vaginal discharge) may be done to rule out other causes of vaginitis. Hormonal studies may be done if the menopausal status is uncertain.

Laboratory tests include:

• Wet preparation/cytological smear of cells from the vagina
  
• Ultrasonography of the uterine lining
  
• Serum hormone concentration
  
• Vaginal pH

What is the treatment?

The lack of circulating, natural oestrogens being the primary cause of atrophic vaginitis, hormone replacement therapy is the most logical treatment and has proved to be effective. Topical oestrogen creams or tablets may be used in the vagina or oral oestrogen replacement therapy may be initiated. Usually this is effective in overcoming the problem. Painful sexual intercourse may be helped by using water-soluble vaginal lubricants. Relief is usually achieved by implementing one or more of the treatments outlined. It is necessary to get medical help in women who are experiencing vaginal soreness, burning, itching, or painful sexual intercourse even after using lubricants.

What is the prevention?

For post-menopausal women in particular, regular sexual activity, with or without a partner, is recommended. Sexual activity improves blood circulation in the vagina, which helps maintain the tissue.