A clinical condition characterized by the thinning, drying, and inflammation of the vaginal walls due to a significant decrease in circulating estrogen levels, typically occurring during menopause or following surgical removal of the ovaries. This leads to symptoms such as dryness, itching, dyspareunia, and increased susceptibility to genitourinary infections. It is a common manifestation of genitourinary syndrome of menopause (GSM).
Origin
The term is derived from the Latin vagina, meaning “sheath,” and the Greek atrophia, meaning “lack of nourishment” or “wasting away.” The clinical recognition of this condition as a direct consequence of hypoestrogenism is fundamental to gynecological endocrinology.
Mechanism
Estrogen is trophic to the vaginal epithelium, promoting cellular proliferation, glycogen accumulation, and maintaining tissue elasticity and blood flow. With estrogen deficiency, the vaginal epithelium thins, the submucosal connective tissue loses collagen, and the pH rises, leading to the characteristic symptoms and structural changes of atrophy and compromised local immunity.
Low-dose vaginal estrogen is generally safe, but its use requires careful evaluation with your oncologist, especially if you take an aromatase inhibitor.
Insulin resistance patterns disrupt female sexual drive by altering sex hormone balance, impairing vascular and nerve function, and influencing neuroendocrine pathways.
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