treatment of atrophic vaginitis

Last edited 06/2019 and last reviewed 11/2023

• malignancy must be excluded
  
  
• non-hormonal treatments
  • lubricants and moisturisers can be used in atrophic vaginitis
    • may be effective in treatment of dyspareunia in women with mild to moderate vaginal dryness
    • useful if contraindication to oestrogen/women does not want to use oestrogen
      
      
• atrophic vaginitis may respond to a short course of vaginal oestrogen and may be required in addition to oral or transdermal HRT (see linked item). The usual dose is daily for two weeks and then twice weekly for up to three months
  • if only vaginal symptoms and no menopausal symptoms then vaginal oestrogen is often used (rather than systemic HRT)
  • approximately 10-25% of women receiving HRT will continue to have symptoms of atrophic vaginitis
    • these women may require topical oestrogen in addition to HRT
      
      
• ospemifene is an alternative treatment for atrophic vaginitis