Written by : Dr.M.D.Mazumdar, MD
Postmenopausal vaginitis is a condition in which decreasing levels of estrogen at the time of the menopause makes the vaginal mucosa thin and atrophic.
The low estrogen level decreases the immunity of the vaginal walls and leaves the mucosa unable to resist infections by pathogenic organisms.
This condition can occur not just after menopause, but also in the premenopausal period when the estrogen levels begin to decrease.
Also called 'Atrophic vaginitis', postmenopausal vaginitis may be accompanied by infections spreading upwards from the vagina to the uterus and downwards all around the vulva.
Some women complain that the itching is so severe that they have to splash cold water on their genital organs in an attempt to control it. Others say that they have to rub themselves hard or press a pillow between their legs at night to control the itching.
Some women may have small patchy areas of ulcers on the vaginal walls. In an old and chronic case of infection, these ulcers may cause the walls of the vagina to stick together, leading to partial closure of the vagina.
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Diagnosis of postmenopausal vaginitis is made only after ruling out all causes of postmenopausal bleeding. A diagnostic D&C (dilatation and curettage) of the uterine lining and the cervix to rule out cancers of the uterus and cervix is a must before starting any treatment.
Ultrasonography of the pelvic organs, examination of smears taken from the vagina and tests for hormone levels in the blood are other investigations usually done before starting treatment.
Premarin pills (1.25mg) can also be taken once a day for 3 weeks and then stopped. If the woman has an intact uterus (that is, if she has not had surgery to remove the uterus), she may have a mild bleeding for a few days within 1 week of stopping Premarin. Premarin is continued for another month if the symptoms persist, but is usually not necessary.
Supplements of various nutrients should be taken - B-Complex Capsules, High strength Multivitamin Capsules , Iron capsules to correct anaemia and Folic Acid tablets should be taken.
Other supplementary vitamins and minerals that can increase the resistance of the body to infections of various types also need to be taken , especially since absorption and metabolism of nutrients and vitamins from the gut decreases at and around the time of the menopause.
Vitamin C 500 mg tablets taken once daily and Zinc tablets helps increase the body's immunity to infection.
Acidophilus tablets encourage the growth of healthy lactobacilli in the vagina and increases the acidity of the vagina to help prevent vaginal infections. Alternatively, a bowl of 200mg yogurt should be taken daily - this will not only help the growth of lactobacilli in the vagina and the gut, but is also a good source of calcium.
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