gynecology and obstetrics
Vaginal Itching and Discharge
Geriatrics Essentials
In postmenopausal women, a marked decrease inestrogencauses the vaginal pH to become less acidic and causes vaginal thinning. Vaginal thinning is one symptom of genitourinary syndrome of menopause. In this syndrome, vaginal inflammation often results in an abnormal discharge, which is scant and may be watery and thin or thick and yellowish. Dyspareunia is common, and vaginal tissue appears fragile and dry. Other common causes of decreasedestrogenin older women include oophorectomy, pelvic radiation, and certain chemotherapy drugs. Low-dose vaginal estrogen is the preferred treatment for genitourinary syndrome of menopause. Poor hygiene (eg, in patients who are incontinent or bedbound) can lead to chronic vulvar inflammation due to chemical irritation by urine or feces. Bacterial vaginosis, candidal vaginitis, and trichomonal vaginitis may occur in postmenopausal women. After menopause, risk of cancer increases, and a bloody discharge is more likely to be due to cancer; thus, any vaginal discharge in postmenopausal women should be promptly evaluated. 