Atrophic Vaginitis

Key takeaways

• Symptoms can include dryness, burning, pain with sex, urinary urgency and recurrent urinary infections.
• Vaginal moisturisers and lubricants have non-hormonal roles; local oestrogen may be considered when symptoms persist.
• Bleeding after menopause should not be assumed to come from atrophy and needs clinical evaluation.

The listings below do not confirm the cause of symptoms; cancer history, unexplained bleeding and hormone risks affect treatment.

Confirming the cause

Examination can identify fragile pale tissue and exclude infection, skin disease, prolapse or a lesion. Swabs or urine tests may be useful when discharge or urinary symptoms are present. Symptoms and findings are now often grouped under genitourinary syndrome of menopause.

Treatment options

Regular vaginal moisturiser supports baseline comfort, while lubricant reduces friction during sex. Low-dose local oestrogen acts mainly at vaginal tissue and has lower systemic exposure than systemic therapy, but suitability still needs review in people with hormone-sensitive cancer or unexplained bleeding.

When to seek urgent care

Arrange prompt assessment for any bleeding after menopause, severe pelvic pain, fever, foul-smelling discharge, inability to pass urine or pain and bleeding when pregnancy is possible.