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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19318
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Dry Vagina and itchiness, sore sometimes some blood on toilet

Customer Question

Dry Vagina and itchiness, sore sometimes some blood on toilet paper when I wipe myself
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. D. Love replied 4 years ago.
It will help if you could provide some further information:
Which hormone tablet are you using?
How long have you been taking this hormone?

Customer: replied 4 years ago.

Not sure of the name of the tablet as i am at work have only used them twice and am on them for 3 weeks

Expert:  Dr. D. Love replied 4 years ago.
Have they been prescribed to be taken once every couple weeks?

Customer: replied 4 years ago.

no to be used every night for 3 weeks

Expert:  Dr. D. Love replied 4 years ago.
Then I'm not sure what you mean by the statement that you have used them twice over the 3 weeks.
Could you clarify what you mean by having used them twice?
Do you mean that you haven't remembered to take them on other days?

Customer: replied 4 years ago.

I was prescribed them on Monday the18th November and started to use them on Wednesday 20th November.

Expert:  Dr. D. Love replied 4 years ago.
OK, so you have only been on the start of a 3 week course that you have already taken for only 2 days.

There are several issues to discuss in this situation.

The most common cause of these symptoms in a woman of your age is atrophic vaginitis. Atrophic vaginitis is a thinning of the lining of the vagina because of the absence of oestrogen after menopause. As the lining thins, it will develop the symptoms that you describe. Dryness and itching is the most common symptoms, and the lining can be more prone to injury, so can have the bleeding that you have noticed.

Although this problem does not need to be treated simply because it is present, and usually is not treated when the symptoms are mild, it is appropriate to treat the problem when the symptoms are more significant. The usual treatment is to use oestrogen, and when the only significant post-menopausal symptoms are related to the atrophic vaginitis, it is appropriate to treat it with intravaginal oestrogens. It is far too early to know whether this treatment will be effective, as it takes at least several weeks of treatment to start seeing a response to the oestrogen, and the maximal responsee can take several months. Many women need chronic treatment because they need that maximal response, but after the first few weeks of treatment, the oestrogen can usually only be given twice per week.

There does need to be some further discussion on the bleeding. Although bleeding can occur with the atrophic vaginitis, it is also usually appropriate to ensure that there is no other problem present. Vaginal bleeding after menopause should always prompt consideration of the possibility of cancer. If the bleeding resolves with the treatment of the atrophic vaginitis, that is a good sign, but there also should be appropriate monitoring to be certain that there is no evidence of any other problems.

If you have any further questions, please let me know.

Expert:  Dr. D. Love replied 4 years ago.
I notice that the question is still open, but I have not received any follow-up questions.

If you have any further questions, please let me know, but if I have answered all your questions, please remember to provide a positive rating.