What Is Atrophic Vaginitis?

Senile vaginitis is common in postmenopausal elderly women. Due to ovarian decline, estrogen levels decrease, vaginal wall shrinks, mucosa becomes thin, glycogen content in epithelial cells decreases, vaginal pH rises, and local resistance decreases. Germs easily invade and cause inflammation. The main symptoms are increased vaginal discharge and itching and burning sensation of the vulva. Examination revealed aging changes in the vagina, epithelial atrophy, wrinkles disappeared, and the epithelium became smooth and thin. The vaginal mucosa is hyperemic, with small bleeding points and sometimes superficial ulcers. If the ulcer surface and the contralateral adhesion, the adhesion can be separated during vaginal examination and cause bleeding, severe adhesions can cause vaginal stenosis or even atresia, poor drainage of inflammation secretions can form vaginal empyema or even uterine pus. Rare.

Basic Information

English name

senilevaginitis

Visiting department

Obstetrics and Gynecology

Multiple groups

Postmenopausal elderly women

Common locations

vaginal

Common causes

Bacterial invasion

Common symptoms

Increased vaginal discharge, thin, pale yellow, itching or burning sensation in the vulva, pain during sexual intercourse, frequent urination, urgency, dysuria and other urinary system irritation symptoms

Causes of senile vaginitis

As ovarian function declines, estrogen levels decrease, vaginal wall shrinks, mucosa becomes thinner, glycogen content in epithelial cells decreases, pH in vagina increases, local resistance decreases, and pathogens easily invade and cause inflammation. At the same time, due to vaginal mucosal atrophy, thin epithelium, and insufficient blood flow, vaginal resistance is reduced, which facilitates bacterial invasion and reproduction to cause inflammatory lesions. In addition, poor personal hygiene habits and nutritional deficiencies, especially B vitamin deficiencies, may be related to the onset of disease. In addition, surgical removal of bilateral ovaries, premature ovarian failure, pelvic radiotherapy, long-term amenorrhea, and long-term breastfeeding can all cause this disease.

Clinical manifestations of senile vaginitis

1. Increased vaginal discharge, thin, pale yellow, severe cases with purulent leucorrhea, smelly.

2. Vulva itching or burning sensation.

3. Vaginal mucosal atrophy may be accompanied by sexual intercourse pain. Sometimes there is incontinence.

4. Infection can also invade the urethra and cause urinary system irritation such as frequent urination, urgency, and dysuria.

5. Gynecological examination showed atrophic changes in the vaginal mucosa, wrinkles disappeared, epithelium was thin and smooth, vaginal mucosa was congested, there were small bleeding points, sometimes superficial ulcers, and the ulcer surface could adhere to the contralateral side. Adhesion could be separated during examination Causes bleeding. Severe adhesions cause vaginal stenosis or even atresia, and poor drainage of inflammatory secretions forms vaginal empyema or uterine empyema.

Diagnosis of senile vaginitis

According to clinical manifestations, diagnosis is generally not difficult, but other diseases should be excluded before diagnosis. Vaginal secretions should be taken for trichomonas and candida to exclude specific vaginitis. Those with bloody leucorrhea should be distinguished from uterine malignant tumors. Pay attention to the size and shape of the uterus and the source of bleeding during gynecological examinations. Cervical curettage should be routinely performed, and segmental diagnosis and curettage should be performed if necessary. Granulation tissue and ulcers in the vaginal wall need to be differentiated from vaginal cancer, and local tissue biopsy is feasible. When chronic inflammation develops, two results can occur: one is the fibrosis of the connective tissue under the vaginal mucosa, the vagina loses its elasticity, and finally the vagina is narrowed and scarred; the other is that vaginal wall adhesions form vaginal atresia, even above the atresia. Vaginal empyema. Although this condition is rare, the condition is serious.

Treatment of senile vaginitis

The principle of treatment is to supplement estrogen, enhance vaginal resistance, and inhibit bacterial growth.

1. Enhance vaginal resistance

Estrogen preparations are given for the cause, either locally or systemically. Pregnancy horse estrone ointment is applied topically, twice a day, or estriol cream, topically, once a day for the first week, and then gradually reduced to the maintenance amount (such as twice a week) according to remission.

2. Inhibit bacterial growth

Rinse the vagina with 1% lactic acid or 0.5% acetic acid solution once a day to increase vaginal acidity and inhibit bacterial growth and reproduction. After vaginal irrigation, topical antibiotics were used.

Senile vaginitis prevention

Increase vaginal acidity and improve vaginal resistance. About 30% of women after menopause develop senile vaginitis. The reason is that women's sex hormone levels are significantly reduced after menopause, which causes the pH in the vagina to rise, the vaginal mucosa to shrink and thin, and the wrinkles to disappear, and the elastic tissue in the vagina to decrease, leaving the vaginal opening open and the walls to bulge. The resistance of the vaginal mucosa to pathogens is weakened, which can easily cause bacterial infection and cause vaginal inflammation. Therefore, elderly women should pay special attention to self-care, pay attention to hygiene, and reduce the chance of vaginal infections in life.

1. When senile vaginitis occurs, do not wash the vulva with hot water due to vulvar itching. Although this can temporarily relieve itching, it will dry and rough the vulva skin, and itching will be more obvious shortly thereafter. When cleaning the vulva, a female care solution with a weak acid formula should be used.

2. Underwear is changed daily during the illness. Underwear should be loose and comfortable, and made of pure cotton fabric.

3. Do not use drugs in discomfort when the vulva appears uncomfortable. Because the bacteria that cause senile vaginitis are mostly E. coli, staphylococcus, etc., unlike women of childbearing age, fungal vaginitis and trichomoniasis vaginitis are most common. Therefore, do not use medicines for the treatment of mold or trichomoniasis, and do not use vaginal vaginitis as vulvar eczema and use hormone creams, which will be counterproductive.

4. Usually pay attention to hygiene and reduce the chance of getting sick. Do not use soap or various liquids to clean the vulva for "sterilization". Because the vulva skin of elderly women is generally dry and atrophic, often cleaning the vulva with soap and other irritating cleaning products will aggravate the dryness of the skin, cause itching, and damage the vulva skin. Use a weak acid formula for feminine care when cleaning the vulva. The selected toilet paper should bear the words "Exact". Change your underwear frequently. Do not mix your own wash basins and towels with others.

5. Because the vaginal mucosa of elderly women is thin and the elastic tissue in the vagina is reduced, it is possible to damage the vaginal mucosa and blood vessels in the mucosa during sexual intercourse, allowing bacteria to invade. Solution: You can apply a small amount of grease to the vaginal opening before sexual life to lubricate the vagina and reduce friction.