Atrophic vaginitis is inflammation of the vagina as a result of tissue thinning due to not enough estrogen. Symptoms may include pain with sex, vaginal itchiness or dryness, and an urge to urinate or burning with urination. It generally does not resolve without ongoing treatment. Complications may include urinary tract infections.The lack of estrogen typically occurs following menopause. Other causes may include when breastfeeding or as a result of specific medications. Risk factors include smoking. Diagnosis is typically based on symptoms.Treatment is generally with estrogen cream applied to the vagina. Other measures that may help include vaginal lubricants. It is recommended that soaps and other irritants are avoided. About half of postmenopausal women are affected. Many however are not being treated. Women often report reduced enjoyment in sex as well as life generally. Signs and symptoms
After menopause the vaginal epithelium changes and becomes a few layers thick. Many of the signs and symptoms that accompany menopause occur in atrophic vaginitis. Genitourinary symptoms include

dryness
pain
itching
burning
soreness
pressure
white discharge
malodorous discharge due to infection
painful sexual intercourse
bleeding after intercourse
painful urination
blood in the urine
increased urinary frequency
incontinence
increased susceptibility to infections
decreased vaginal lubrication
urinary tract infections
painful urination
difficulty sitting
difficulty wiping

Diagnosis
Since women can have signs and symptoms that could be attributed to other causes, diagnosis is based upon the symptoms that cannot be better accounted for by another diagnosis. Lab tests usually do not provide information that will aid in diagnosing. A visual exam is useful.
Recommendations for the use of the lowest effective dose for the shortest duration  help to prevent adverse endometrial effects.Some treatments have been developed more recently. These include selective estrogen receptor modulators, vaginal dehydroepiandrosterone, and laser therapy. Other treatments are available without a prescription such as vaginal lubricants and moisturizers. Vaginal dilators may be helpful. Since GSM may also cause urinary problems related to pelvic floor dysfunction, a woman may benefit from pelvic floor strengthening exercises. Women and their partners have reported that estrogen therapy resulted in less painful sex, more satisfaction with sex, and an improvement in their sex life. Epidemiology
Up to 50% of postmenopausal women have at least some degree of vaginal atrophy. It is likely to be underdiagnosed and undertreated. Terminology
Vulvovaginal atrophy, and atrophic vaginitis have been the preferred terms for this condition and cluster of symptoms until recently. These terms are now regarded as inaccurate in describing changes to the entire genitourinary system occurring after menopause. The term atrophic vaginitis suggests that the vagina is inflamed or infected. Though this may be true, inflammation and infection are not the major components of postmenopausal changes to the vagina. The former terms do not describe the negative effects on the lower urinary tract which can be the most troubling symptoms of menopause for women. Genitourinary syndrome of menopause (GSM) was determined to be more accurate than vulvovaginal atrophy by two professional societies. The term atrophic vaginitis does not reflect the related changes of the labia, clitoris, vestibule, urethra and bladder.