After menopause, when the ovaries no longer produce estrogen, vaginal changes occur. The vagina can become dry, leading to changes in the normal germs inside. Up to 50% of women may experience symptoms, which include:
- Vaginal discharge from overgrowth of different germs
- Minor tears in tissue, with bleeding
- Painful or uncomfortable sex; low libido (low desire for sex)
- Burning or itching in the vagina, especially during urination (this can mimic urinary tract infections, even though there are no germs in the bladder)
Half to 75% of women may experience one or another of these, but many never mention it to their healthcare providers, perhaps because they simply consider it normal, or out of embarrassment. Atrophic vaginitis can occasionally occur in younger women whose estrogen levels drop for a variety of reasons.
Physical changes are evident on pelvic exam. Tests aren’t necessary for diagnosis, unless the major symptom is vaginal discharge or urinary burning, in which cases we’d likely want to rule out different infections. Various treatments are available.