From the Guidelines
Vaginitis and vaginal atrophy are distinct vaginal conditions with different causes and treatments, and the most recent and highest quality study 1 suggests that vaginal atrophy, also called genitourinary syndrome of menopause, results from decreased estrogen levels causing thinning, drying, and inflammation of vaginal tissues.
Causes and Symptoms
Vaginitis is an inflammation or infection of the vagina typically caused by bacterial vaginosis, yeast infections, or trichomoniasis, characterized by abnormal discharge, odor, itching, and irritation.
- Bacterial vaginosis is associated with an imbalance of vaginal flora
- Yeast infections are caused by Candida species
- Trichomoniasis is a sexually transmitted infection On the other hand, vaginal atrophy is a chronic condition related to estrogen deficiency, with symptoms including vaginal dryness, burning, painful intercourse, and urinary problems.
Treatment
Treatment depends on the specific cause:
- For bacterial vaginosis: metronidazole (500mg twice daily for 7 days) or clindamycin
- For yeast infections: fluconazole (150mg single dose) or topical antifungals like miconazole
- For trichomoniasis: metronidazole or tinidazole For vaginal atrophy, treatment typically involves:
- Topical estrogen (creams, tablets, or rings)
- Systemic hormone therapy
- Non-hormonal moisturizers and lubricants like Replens or K-Y Jelly As noted in the study 1, vaginal estrogens are effective in relieving symptomatic atrophic vaginitis, and there is some evidence that vaginal estrogens may be superior to systemic treatment for vaginal dryness.
Key Differences
The key difference between vaginitis and vaginal atrophy is that vaginitis is primarily an infection or inflammation requiring antimicrobial treatment, while vaginal atrophy is a chronic condition related to estrogen deficiency requiring ongoing management with hormone replacement or moisturizers, as supported by the study 1.
From the Research
Vaginitis vs Vaginal Atrophy
- Vaginitis is a disorder responsible for more than 10% of visits made to providers of women's health care, with vaginal infections being the most common cause 2.
- The diagnosis of vaginitis requires a medical history, examination, and skillful performance of office laboratory procedures, including the vaginal pool wet mount examination, determination of the vaginal pH, and the whiff test 2.
- Vaginal atrophy, on the other hand, is a common manifestation of estrogen decline associated with specific symptoms, including vaginal dryness, itching or irritation, and dyspareunia 3, 4.
- The assessment of vaginal atrophy can be done through subjective measurements, such as the most bothersome symptoms approach, and objective measurements, including the vaginal maturation index and vaginal pH measurement 3, 4.
Key Differences
- Vaginitis is often caused by infections, such as Candida or Trichomonas, and can be treated with antifungal or antibiotic medications 2, 5.
- Vaginal atrophy is a result of estrogen decline and can be treated with hormone replacement therapy or other medications aimed at alleviating symptoms 3, 4.
- The diagnosis of vaginitis often involves laboratory tests, such as wet mount examination and vaginal pH determination, while the diagnosis of vaginal atrophy relies on a combination of subjective and objective measurements, including symptom assessment and vaginal maturation index 2, 3, 4.
Similarities
- Both vaginitis and vaginal atrophy can cause symptoms such as vaginal discharge, itching, and irritation 2, 3, 4.
- Both conditions can have a significant impact on a woman's quality of life and require proper diagnosis and treatment to alleviate symptoms 2, 5, 3, 4.
- The use of simple and rapid diagnostic tools, such as vaginal fluid wet mount microscopy and vaginal pH determination, can be useful in the diagnosis of both conditions 6.