Obgyn: Atrophic Vaginitis: Free MSRA Podcast

⚕️FREE MSRA PODCAST –Atrophic Vaginitis🎧 A high-yield breakdown of this common postmenopausal condition – covering causes, diagnosis, and NICE-basedmanagement with clarity and clinical relevance.🧠Key Learning Points📌Definition• Atrophic vaginitisis inflammation of the vaginal tissue dueto oestrogen deficiency• Also known as vaginal atrophy or genitourinary syndrome of menopause (GSM) – affecting the vagina, vulva, urethra, and bladder📌Causes & RiskFactors• Menopause – most common cause• Surgical menopause (e.g. oophorectomy)• Cancer treatments – radiotherapy, chemotherapy• Anti-oestrogen medications – e.g. aromatase inhibitors• Postpartum and breastfeeding (temporary lowoestrogen)• Smoking – accelerates oestrogen decline📌Pathophysiology• ↓ Oestrogen →thinning of vaginal mucosa, ↓ elasticity, ↓ lubrication• ↓ Blood flow andtissue resilience → dryness, irritation, inflammation• Loss of protectiveacidic pH → ↑ risk of infection📌Symptoms• Vaginal dryness (up to 93% of patients, with68% reporting moderate to severe symptoms)• Irritation, itching, burning• Dyspareunia (painful intercourse)• Postcoital bleeding• Urinary symptoms: dysuria, nocturia, frequency,urgency, recurrent UTIs• Reduced libido, arousal, and orgasmdifficulties📌DifferentialDiagnosis• Infective causes: Candida, BV, trichomoniasis• Dermatoses: lichen sclerosus, contactdermatitis• Postmenopausal bleeding from other causes• Irritant exposures: soaps, perfumes, detergents• Diabetes-related symptoms💡Tip: Vaginal pH >5 suggests atrophy but overlapwith infection is possible📌Diagnosis• Clinical – based on history and pelvic examination• Vaginal pH testing(typically >5)• Vaginal swabs –rule out infection• Consider bloodglucose, cytology or biopsy if red flags present💡 No investigations needed if diagnosis is clearfrom symptoms and exam📌Management🩺First-line (mild):• Vaginal moisturisers (regular use)• Lubricants during intercourse🩺Moderate to severe:• Topical oestrogen: creams, tablets, rings– Well tolerated, low systemic absorption• Systemic HRT – if treating broader menopausalsymptoms🩺Adjuncts:• Vaginal dilatorsor regular sexual activity• Avoid irritants(fragranced products, tight synthetic underwear)🩺Emerging options:• Laser therapy, prasterone,ospemifene – guided by individual factorsand clinician preference📌Important: Unexpected bleeding while on hormonal therapy →urgent review📌Complications• Recurrent UTIs, chronicdiscomfort• Sexual dysfunction• Increased risk of infections• Undiagnosed atrophy may delay appropriatetreatment📌Prognosis• Unlike vasomotor symptoms, atrophic symptoms do NOT improve over time• Symptoms may return if treatment stops• Early recognitionand long-term management key to improvingquality of life📎More MSRA Resourcesfor Atrophic Vaginitis📝 Revision Notes: https://www.passthemsra.com/topic/atrophic-vaginitis-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/atrophic-vaginitis-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/atrophic-vaginitis-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/atrophic-vaginitis-rapid-quiz/🧪 Quiz Bank: https://www.passthemsra.com/quizzes/atrophic-vaginitis/🎓 Full Course: https://www.passthemsra.com/courses/obstetrics-and-gynaecology-for-the-msra/Hashtags#MSRA #MSRARevision#MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQANotes#MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision#MSRARevisionWebsite #AtrophicVaginitis #GSM #VaginalAtrophy#ObsAndGynaeForMSRA