VAGINITIS, POSTMENOPAUSAL

General Information

DEFINITION--Infection or inflammation of the vagina caused by lowered estrogen levels that upset the vagina's normal hormone and pH balance. Postmenopausal vaginitis is not contagious.

BODY PARTS INVOLVED--Vagina.

SEX OR AGE MOST AFFECTED--Women over age 40.

SIGNS & SYMPTOMS--

Severity of the following symptoms varies greatly between women and from time to time in the same woman.

• Bad-smelling vaginal discharge. The discharge is usually thin, whitish and sometimes tinged with blood.
• Genital pain and itching.
• Discomfort during sexual intercourse.
• Change in vaginal color from pale-pink to red.

CAUSES--

Germs that inhabit the vagina cause infection when the normal physiology of the vagina is disturbed. After menopause, the estrogen level that helped maintain a normal vaginal environment decreases, leaving the vagina more vulnerable to infection. The following conditions increase the likelihood of post-menopausal vaginitis:

• General poor health.
• Hot weather, non-ventilating clothing--especially underwear--or any other condition that increases genital moisture, warmth and darkness. These foster the growth of germs.

RISK INCREASES WITH

• Diabetes.
• Illness that has lowered resistance.
• More frequent sexual intercourse.

> Don't sit around in wet clothing--

especially a wet bathing suit.

• After urination or bowel movements, cleanse by wiping or washing from front to back (vagina to anus).
• Lose weight if you are obese.
• Avoid frequent douches.
• If you have diabetes, adhere strictly to your treatment program.
• Ask your doctor about replacement estrogen.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam (including pelvic exam) by a doctor.
• Laboratory studies, such as a Pap smear (See Glossary), and microscopic exam and culture of the vaginal discharge and biopsy (See Glossary).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Drug therapy will be directed to the specific organism. Your sexual partner may need treatment also. It is best not to do self-treatment for the disorder until the specific cause is determined.

POSSIBLE COMPLICATIONS--Secondary bacterial infection in any pelvic organ.

PROBABLE OUTCOME--Usually curable in 10 days with treatment.

How To Treat

GENERAL MEASURES--

• Don't douche unless your doctor recommends it.
• If urinating causes burning, urinate through a tubular device, such as a toilet-paper roll or plastic cup with the end cut out, or pour a cup of warm water over genital area while you urinate.

MEDICATION--Your doctor may prescribe:

• Topical or oral estrogen. If you use a cream or suppository, use a small sanitary pad to protect clothing. Keep creams or suppositories in the refrigerator. After treatment, you may want to keep a refill of the medication so you can begin treatment quickly if the condition recurs. Follow the prescription directions carefully.
• Other creams, ointments or suppositories to suppress the organisms causing the infection.

ACTIVITY--Avoid overexertion, heat and excessive sweating. Delay sexual relations until you are well.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of vaginitis.
• Symptoms persist longer than 1 week or worsen, despite treatment.
• Unusual vaginal bleeding or swelling develops.
• After treatment, symptoms recur.