Vaginal atrophy is a change of the vagina that develops when there is a significant decrease in levels of the female hormone estrogen. Symptoms include dryness, irritation, and painful intercourse. Low estrogen levels can come from menopause, after delivery, or with the use of oral contraceptive pills.

A related condition is "urogenital atrophy." The term is used when bladder symptoms such as urgency and frequency result from low estrogen.

Vaginal and urogenital atrophy are often successfully treated with over-the-counter lubricating products such as Replens, KY jelly and Astroglide. They provide moisture to the vaginal surface. If they do not provide adequate relief, vaginal estrogen is very effective and safe when used properly.

Estrogen applied directly to the vagina as a cream or suppository reverses the changes of atrophy. The lining grows thicker and natural secretions are increased. Estrogen can be absorbed into the system through the vagina. Only very low doses are required, and the amount absorbed is considered safe even for long-term use.

An alternative way to provide estrogen is called Estring. This soft plastic ring contains estrogen. It is worn continuously in the vagina for three months and then replaced. It releases a constant low dose of estrogen directly to the vaginal tissues. There is no measurable increase in blood levels of estrogen with the Estring. This makes it safe for long-term use.