Diagnosis and management of vaginal dryness in menopause

vaginal dryness diagnosis management menopause hormonal therapy (HT)


  • Ali Baziad
    Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta
31 March 2018


Objective: To review the diagnosis and management of vaginal dryness in menopausal women

Methods: Literature review

Results: Lack of estrogen negatively impacts the vagina and the urinary tract. The vagina becomes dry (atrophic) and then causing pain during sexual intercourse. Vaginal atrophy can be diagnosed in the form of vaginal dryness (75%), painful sexual intercourse (38%), itching and discharge complaints. Sometimes the patient complained pain in urinating, frequent night urination, in-continence and recurrent urinary tract infections. Mucose of the cervix, vagina and vulva are thin. Vagina can bleed easi-ly. Diagnosis can also be made by measuring the pH of the vagina by using litmus paper and vaginal cytology. The management involves administration of local estrogen treatment using weak estrogen (E3) in the form of a cream. E3 cream does not need to be combined with progestogen. Other type of local hormonal therapy (TH) is DHEA cream. Giving a strong estrogen (E2) or equin estrogen should always be combined with progestogen to prevent endometrium hyperplasia, either administered locally or systemically. E3 cream is also safe in women with breast cancer who experienced vaginal atrophy.

Conclusion: Lack of estrogen causes vaginal atrophy with symptoms of vaginal dryness. Vaginal atrophy also causes urinary problems. Diagnosis is based on symptoms, examination of vaginal pH and vaginal cytology. The management is by adminis-tering HT with estrogen. E3 creams is the most effective in relieving complaints caused by vaginal dryness and complaints caused by the bladder.