Overview

• Vaginal irritation caused by thinning of the vaginal epithelium.
• Due to reduction in circulating oestrogen levels.
  • Risk Factors → post-menopausal, prolonged lactation.
• Occurs in 10-40% of postmenopausal women.

Making Diagnosis

Clinical Features

• Vaginal dryness.
• Dyspareunia.
• Postmenopausal bleeding.
• O/E → vagina is pale and dry. Vaginal examination may be painful.

<aside> 💡 Any woman ≥55 years old with PMB should be referred to 2WW pathway (even if vaginal atrophy is suspected).

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Investigations

• Clinical → may swab for any infections or biopsy for any malignancies or ulcers.

Management Plan

• Topical Oestrogen Cream.
• Bleeding on Intercourse → water-based moisturisers and lubricants.