What is atrophic vaginitis? Atrophic vaginitis is the thinning and inflammation of vaginal tissues due to a drop in estrogen levels. This is accompanied by a decrease in lubrication. Symptoms of atrophic vaginitis include itching, burning and discomfort; sometimes a bad-smelling, yellowish discharge may be present. Sexual intercourse may be painful and may be followed by light bleeding. Estrogen is a female hormone that plays many roles, including keeping the vaginal tissue healthy and lubricated. Estrogen levels naturally drop during menopause; therefore, atrophic vaginitis mostly affects postmenopausal women. It is estimated that 10% to 40% of all postmenopausal women have symptoms related to atrophic vaginitis (Source: AAFP). Estrogen levels can also be decreased by medications, excessive exercising, anorexia, stress, or depression. Estrogen-reducing medications include hormones used to treat endometriosis, infertility, fibroids, and breast cancer and also some chemotherapy agents. In addition, treatment of cancer with pelvic radiation can reduce estrogen levels, as does surgical removal of the ovaries. Estrogen levels also drop right after a baby is born and while breastfeeding. Symptoms of vaginal atrophy typically resolve with treatment, which may include prescription estrogen or over-the-counter moisturizing creams or lubricants. Estrogen can be given in a pill to be swallowed or in a variety of forms, such as creams, gels, suppositories or tablets, to be placed in the vagina. Infections, irritants, allergic reactions, cancer, and other conditions can cause symptoms similar to those of atrophic vaginitis. Seek prompt medical care if you have symptoms of atrophic vaginitis or if you are being treated for it but symptoms recur or are persistent.