Less common vaginal problems in women over 50 are:
Sexually transmitted infections (STIs).
Cancer of the vagina, which is rare.
Abnormal vaginal bleeding (unless still menstruating or on hormone therapy).
It is common for menstrual periods to be irregular for several years before menopause. You should discuss any changes in your cycle with your health care provider. For premenopausal women, the most common causes of abnormal vaginal bleeding, in this order, are: Not ovulating; malignancy; pregnancy; endometriosis; and benign tumors. The most common cause of abnormal vaginal bleeding after menopause is malignancy.
The chart lists signs and symptoms of vaginal problems and what to do about them. {Note: All vaginal bleeding that occurs after menstruation has stopped or when there is a possibility of pregnancy should be evaluated by your doctor.}
SIGNS & SYMPTOMS
WHAT IT COULD BE
WHAT TO DO
Vaginal bleeding with:
A known bleeding disorder and you also have blood in your urine or stool
Heavy vaginal bleeding after taking a clot-dissolving drug for a heart attack or stroke
Hemorrhage
Get immediate care
Vaginal bleeding after trauma to the abdomen, pelvis, or vagina or vaginal bleeding with any of these problems:
Dizziness and very heavy bleeding (you saturate more than 1 full sized pad in an hour’s time)
Pale and moist skin and a decreased level of consciousness
Extreme shortness of breath or a very hard time breathing
Severe abdominal pain
Internal injury
Get immediate care
Vaginal bleeding with 2 or more of these problems:
Abdominal tenderness and/or bloating
Pain in the pelvis or back
Pain during intercourse
Skin on your abdomen feels sensitive
Vaginal discharge with abnormal color or odor
Change in menstrual flow, if still menstruating
Fever, chills
Pelvic Inflammatory Disease (PID). This is an infection of the uterus, fallopian tubes, and/or ovaries.
Contact doctor
Vaginal bleeding after menopause, unless on estrogen therapy (ET)
Infection of the cervix, uterus, or vagina. Cervical, uterine, or vaginal cancer.
Contact doctor
Abnormal vaginal bleeding with:
Mild itching and burning around the vagina
Burning or pain when urinating or urinating more often
A vaginal discharge with abnormal color
Abdominal discomfort
Gonorrhea or similar sexually transmitted infection (STI)
Contact doctor
Sores and/or painful blisters in the genital area and sometimes on the thighs or buttocks
Genital herpes
Contact doctor
Vaginal itching, burning, and redness
Greenish-yellow vaginal discharge
Burning or pain when urinating
Trichomoniasis
Contact doctor
Mild vaginal irritation, itching or burning
A thin, gray, or milky white vaginal discharge. This has a fishy odor, which is noticed more after sex. (About half of females have no symptoms.)
Bacterial vaginosis. This is an infection from one or more types of bacteria that may or may not be sexually transmitted.
Contact doctor
Vaginal dryness, irritation, itching, and burning. Pain during sex.
Atrophic vaginitis. This is caused by a decrease in estrogen.
Contact doctor
Itching, irritation, and redness around the vagina
Thick, white vaginal discharge that looks like cottage cheese and may smell like yeast
Burning and/or pain when urinating or with sex
Vaginal yeast infection
Use self-care
Itching and redness in the outer genital area without other symptoms
Vaginitis from contact dermatitis
Use self-care
Care
Medical treatment depends on the cause.
Atrophic Vaginitis
Use a prescribed estrogen cream or prescribed estrogen pills.
Bacterial Vaginosis
Use a prescribed antibiotic cream or gel or prescribed antibiotic pills.
Vaginal Yeast Infection
It is important, though, to make sure that you have the right problem diagnosed. A burning sensation could be a symptom of a urinary tract infection caused by bacteria, which requires an antibiotic. Antibiotics will not help yeast infections. They make them worse. Trichomoniasis mimics yeast infections, too.
Chronic vaginal infections can be one of the first signs of diabetes, sexually transmitted diseases, or HIV in women.
Self-care measures treat most vaginal yeast infections. Your doctor can prescribe a vaginal cream or suppositories or an oral antifungal medicine, such as Diflucan.
Severe Case of Contact Dermatitis in the Vaginal Area
Use an ointment prescribed by your doctor.
Other medical treatments are treating the specific cause, such as STIs, cervical cancer, and uterine cancer.
Self-Care / Prevention
Vaginal Dryness and Painful Intercourse
Don’t use deodorant soaps or scented products in the vaginal area.
Use a water soluble lubricant, such as K-Y Jelly, Replens, etc. Avoid oils or petroleum-based products.
Use an estrogen cream for the vagina. Your doctor needs to prescribe this.
Maintain sexual health.
Don’t use antihistamines unless truly needed.
Contact Dermatitis in the Vaginal Area
Avoid products that cause the problem (scented items, douches, etc.).
Apply an over-the-counter hydrocortisone cream to the affected area. Use this infrequently, though. Hydrocortisone can, itself, lead to thinning of the vaginal tissue. Follow package directions and contact your health care provider.
Put a cool compress on the affected area.
Wash your underwear in a gentle detergent. Rinse it twice. Use only plain water for the second rinse. Don’t use a fabric softener.
Vaginal Yeast Infection or Bacterial Vaginosis
Bathe or shower often. Clean the inside folds of the vulva. Dry the vaginal area well.
Wipe from front to back after using the toilet. Wear all-cotton underwear. Don’t wear garments that are tight in the crotch.
Change underwear and workout clothes right away after sweating.
If you still menstruate, use unscented tampons or sanitary pads and change them often.
Don’t use bath oils, bubble baths, feminine hygiene sprays, or perfumed or deodorant soaps.
Don’t sit around in a wet bathing suit. Shower after you swim in a pool to remove the chlorine from your skin. Dry the vaginal area well.
Eat well. Include foods that contain live cultures of “lactobacillus acidophilus,” such as yogurt. If you can’t tolerate yogurt, take an over-the-counter product that contains lactobacillus acidophilus.
Let your doctor know if you tend to get yeast infections whenever you take an antibiotic. He or she may have you also take a vaginal antifungal agent.
Use an over-the-counter product for vaginal yeast infections, such as Monistat, Gyne-Lotrimin, etc. if recommended by your health care provider.
Avoid douching unless recommended by your health care provider.
