Atrophic Vaginitis

Postmenopausal F with h/o chemo/radiation therapy, premature ovarian failure, and oophorectomy presents with insidious onset vaginal itching and clear discharge. Reports dyspareunia. Inflammation and thin, friable mucosa noted on speculum exam.

• Start estradiol 10 mcg vaginal insert daily for two weeks and then twice weekly thereafter

• Pt advised to use lubricant during sexual activity to reduce discomfort

Notes

• <10% of vaginitis cases

• May also occur in lactating women