My sister is suffering from severe vaginal pain. What to do?

Question

Hi doctor,

I need an opinion regarding my elder sister. She is 52 years old. She is diabetic and is suffering from severe vaginal pain for the last few weeks. While collection of pap smear, the swab was bloody and it was very painful for her. She is currently using Candid cream and Candid V6 tablet for vaginal insertion. I have attached the reports of pap smear and CEA - carcinoembryonic antigen serum test. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

The reports of both pap smear and tumor markers are within normal limits and rules out any malignancy in terms of possible cervical cancer. However, the pain in vagina and blood tinge at her age, where she is likely menopausal, could be due to atrophic vaginitis. There will be severe burning sensation and vaginal dryness, which can cause pain especially on moving or walking. It is important to get the FSH (follicle stimulating hormone), LH (Luteinizing hormone) and serum estradiol levels done. If the estradiol levels are low, then she can be prescribed Estriol vaginal cream for local application inside vagina thrice a week for three weeks to supplement estrogen and rejuvenate the vaginal mucosa and allow natural lubrication.

1. What other symptoms does she experience besides that pain?

2. Is she sexually active? If yes, then any pain or bleeding during intercourse?

Answer 2

Hi,

Welcome back to icliniq.com.

In that case I think she does have atrophic vaginitis due to post menopausal status. You should get it confirmed by a gynecologist after the tests which I have mentioned. I am sure that she should be benefitted with estrogen supplementation as vaginal cream.