Atrophic vaginitis, or vaginal atrophy, is the thinning and inflammation of the vaginal walls due to a decline in the hormone estrogen. Women most commonly experience vaginal atrophy following menopause, but the condition can occur anytime a woman's estrogen levels decline. Symptoms of atrophic vaginitis include vaginal dryness, burning, watery discharge, urinary urgency and light bleeding during intercourse. Treatment for atrophic vaginitis includes replacing the estrogen and restoring the hormonal balance.
Vaginal Estrogen Cream
Physicians may prescribe many different types of estrogen creams. Women using estrogen cream insert the cream into the vagina with an applicator, most often at bedtime. Physicians will determine dosing dependent upon severity of estrogen depletion. Women will usually apply the cream daily for the first few weeks and then taper off to two to three times a week thereafter. Long-term use of estrogen replacement cream may increase the risk of breast cancer, heart attack or stroke. Side effects may include nausea, vomiting, loss of appetite, swollen breasts, acne or skin color changes, decreased sex drive, migraine headaches, dizziness, swelling in the ankles and depression. Serious side effects may occur while using estrogen cream including jaundice, chest pain, sudden numbness or weakness, sudden headache, confusion, abnormal vaginal bleeding, pain or swelling in the lower legs, and problems with vision, speech or balance. Patients should notify physicians if they experience any of these symptoms.
Vaginal Estrogen Ring
The estrogen ring is a soft, flexible ring inserted into the vagina by a physician. The ring releases a consistent dose of estrogen and is replaced every three months. Women older than 65 years old are at greater risk for stroke, invasive breast cancer and memory problems while undergoing treatment with the estrogen ring. A risk for drug interactions exists and women should tell physicians about all current medications including over-the-counter drugs and herbal supplements. Side effects are rare but may include breast pain, enlarged breasts, vaginal itching, headache, nausea, stinging and redness of the genital area and thick, white vaginal discharge with or without odor.
Vaginal Estrogen Tablet
The estrogen tablet is a tablet administered intravaginally with an applicator. Physicians will determine exact dosing but patients commonly take one tablet daily for two weeks, followed by one tablet twice weekly. Women should not take the estrogen tablet if they have a history of genital bleeding, history of breast cancer or history of deep vein thrombosis or pulmonary embolism. Side effects may include nausea, vomiting, swollen breasts, decreased sex drive, skin color changes, vaginal pain and swelling of the ankles.
