Atrophic Vaginitis

Hello - Back in January of this year, you posted a question from a lady who was complaining of itching, burning, etc. and you wrote, "A SECOND possibility is that you may be having some atrophic vaginitis....The earliest symptoms are decreased vaginal lubrication, dryness, itching, burning, pain with intercourse, and feeling of pressure".  I also have this, the most uncomfortable being the intense pressure I sometimes feel, which I think is the worst feeling I have ever had in my life.  It feels as if I have a bad urinary infection, but the doctor will find no signs of bacteria in my urine. I have a blood disorder where I get blood clots, for which I take Coumadin.  Naturally, I cannot take estrogen in any form because of this, so I have suffered with these symptoms for over a year now.  My question is - if the uncomfortable feelings are caused by a lack of estrogen, does this mean they will never go away?  I know that other symptoms of menopause, such as hot flashes, eventually stop.  But does the vaginal discomfort that so many of us feel ever go away, too?  It would be much more tolerable if we could see a silver lining somewhere in the future where we know these uncomfortable symptoms will gradually ease off and we can feel normal again.  There are times when I'll go for a couple of months feeling wonderful, then I'll start feeling the pressure again, sometimes for just a day or so, other times for a week or so.  Then it goes away just as fast as it came.  I've felt so bad on two occasions that I've gone to my doctor thinking maybe I had an infection, but my urine will be fine and he simply says it's just something my body is going through right now.  Which I understand but it would put my mind at ease if I knew I could look forward to a time when I won't feel like this anymore.  Or is this something I will always have?  
Thanks so much for any information you can give me.

[Forum-M.D.-DT]

Thank you for visiting the Family Practice forum.
Well, it sure sounds like you are experiencing Atrophic Vaginitis. Now, I agree that with a history of blood clots, estrogen is not a wise choice. However, I have a couple of thoughts. Firstly, the amount of estrogen absorbed through the vaginal lining is minimal. Using estrogen cream in combination with coumadin is in all liklihood SAFE. Of course, this is up to you and your physician to decide, however, if you were MY patient, I would likely try estrogen cream. Secondly, I have had occasion to use Xylocaine cream for the pain and discomfort of atrophic vaginitis. Talk to your doctor about these options.
I hope all turns out well!

[HoosierState]

I was diagnosed with atrophic vaginitis after my last yearly gynocological exam, tho' I wasn't informed about it until I asked for a copy of my records.  I am already taking estrogen (Tri-Est), a bio-identical estrogen cream, and, according to recent saliva tests, I am taking the correct amount.  However, I have extreme itching from the vaginitis (no discharge, no infection).  Sometimes it can almost drive me crazy!  What can I do about it?  I wear all-cotton underwear and wash them in perfume- and dye-free detergent.  I use no fabric softener.  Can I use the estrogen cream in the genital area?  Will that help?