Which among the following is the treatment of choice for senile vaginitis?
Intravaginal application of estrogen cream is the treatment of choice in senile vaginitis. Since 1/3rd of the vaginal estrogen is systemically absorbed, this treatment is contraindicated in women with a history of breast or endometrial cancer. In senile vaginitis, the vaginal epithelium is thinned and and is susceptible to trauma and infection. Patients presents with vaginal dryness, spotting, presence of serosanguinous or watery discharge and dyspareunia. On examination, the vaginal mucosa appear thinned with few or absent vaginal folds. The pH is 5-7 and wet mount shows small, rounded parabasal epithelial cells and an increased number of polymorphonuclear cells. Ref: Bornstein J. (2013). Chapter 39. Benign Disorders of the Vulva & Vagina. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e
Oral pills
Nystatin locally
Oestrogen cream
Ketoconazole