Atrophic Vaginitis treatments

[Deb1023]

Hello - I am 59 and have atrophic vaginitis. There is an area in the (introitus?) that has almost no skin covering due to the thinning tissue. It burns terribly all the time. I have had numerous vaginal infections over the past few months including gardnerella, a yeast inf., & 2 cultures showed large amounts of enterococcus faecalis & klebsiella. I was treated with Vancomycin for the eterococcus & later was told that was totally ineffective because it is used only for the colon  for colitis & doesn't reach the vaginal area at all. I was given Cipro for the klebsiella, & later told by another gynecologist that he wouldn't have even treated it & didn't believe in doing cultures because something will always show up. He only treats the main infections like BV, Trich., & yeast. Anyway, that's the background. Recently I got this horrible burning, shortly after being treated for infections with metroGel & diflucan. The burning was relentless & severe with some itching as well. My current gynecologist diagnosed atrophic vaginitis & said that in the area that burns  my skin is down to the blood capillaries with almost no protection, hence the burning. I was already using premarin cream nightly, but he switched me to VagFem tabs & Estrace cream to apply directly on the "bad area."
I reacted to something in the estrace & the inflammation & burning got worse. He stopped that & now wants me to use Clobetisol cream (a thin film over the bad area) 3 x daily for a week, then 2 x daily for a week, & then once a day for a week. Is this a common treatment? My pharmacist says it isn't formulated for vaginal use internally & doesn't recommend it. He said it will really sting & burn. I tried some of my old premarin cream after stopping the estrace because I couldn't stand the burning, & it calmed things a lot & the inflammation improved too. I would rather try that for awhile instead of the steroid cream. What do you think? Please give your opinion.Thank you!!

[Elaine Brown, MD]

Hi!
If you were my patient, I would encourage you to start some probiotics.  These contain the "good" bacteria that are supposed to live in the vagina and fight off the "bad" bacteria.  All of the antibiotics you have taken have probably destroyed your normal healthy bacteria.
Also, clobetasol IS a common treatment for inflammation/ dermatitis.  It WILL help to calm down an allergic reaction.  It will also make your tissues thinner though. If your premarin cream is working well, you may want to stick with that.
One other thing to consider is an Estring.  This is a vaginal insert that releases estrogen, and can work very nicely for atrophic vaginitis.
Good luck!
Dr B

[01reddog]

I HAVE REDNESS  AND BURNING(LIKE HECK) FOR 3 MONTHS!  MY FAMILY PHYSICAN PRESCRIBED PREMARIN TO NO AVAIL, THEN A PRESCRIPTION FOR AN YEAST INFECTION TO NO AVAIL, SENT TO A GYN PHYSICAN, SAID I HAD DERMATITIS PRESCRIBED CLOTRIMAZOLE & BETAMETHASONE TO NO AVAIL, DID A BIOPSY NEGATIVE RESULTS, THEN PRESCRIBED CLOBETASOL, HAVE USED AS DIRECTED ALSO TO NO AVAIL.  I AM AT MY WITS END AS WHAT TO DO NEXT----------THE BURNING/REDNESS IS OF THE VULVA AND DOWN THE THIGHS IS EXTREMELY PAINFUL...........ANYONE/ANYBODY HAVE HAD THIS?  DO YOU HAVE THE ANSWER I NEED SO DESPERATELY, PLEASE RESPOND.  J.A. N.