Postmenopausal vaginitis

The importance of vaginitis in postmenopausal women will increase as the US population ages. With the withdrawal of estrogen, the vaginal environment changes dramatically. Along with physical changes, an overall decrease in the normal Lactobacillus-dominant flora and Candida colonization occurs. Trichomoniasis-, vulvovaginal candidiasis, and bacterial vaginosis still occur in menopausal women but probably less commonly than in younger women. The effects of exogenous estrogen on these conditions remain unknown. Less common conditions such as desquamative inflammatory vaginitis and lichen sclerosus gain relative importance in this population.