Atrophic vaginitis

1. Reduced endogenous estrogen causes thinning of the vaginal epithelium. Symptoms include vaginal soreness, postcoital burning, dyspareunia, and occasional spotting. The vaginal mucosa is thin with diffuse erythema, occasional petechiae or ecchymoses, and few or no vaginal folds. There may be a serosanguineous or watery discharge with a pH of 5.0-7.0.

2. Treatment consists of topical vaginal estrogen. Vaginal ring estradiol (Estring), a silastic ring impregnated with estradiol, is the preferred means of delivering estrogen to the vagina. The silastic ring delivers 6 to 9 pg of estradiol to the vagina daily. The rings are changed once every three months. Concomitant progestin therapy is not necessary.

3. Conjugated estrogens (Premarin), 0.5 gm of cream, or one-eighth of an applicatorful daily into the vagina for three weeks, followed by twice weekly thereafter is also effective. Concomitant progestin therapy is not necessary.

4. Estrace cream (estradiol) can also by given by vaginal applicator at a dose of one-eighth of an applicator or 0.5 g (which contains 50 pg of estradiol) daily into the vagina for three weeks, followed by twice weekly thereafter. Concomitant progestin therapy is not necessary.

5. Oral estrogen (Premarin) 0.3 mg qd should also provide relief.

Bacterial Vaginosis Facts

Bacterial Vaginosis Facts

This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.

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