Post-menopausal atrophic vaginitis is best treated with which local therapy?

• A. Podophyllin solution.
• B. Estrogen cream.
• C. Corticosteroid cream.
• D. Boric acid solution.

Answer: (C)

Atrophic vaginitis after menopause is caused by reduced estrogen leading to thinning of the vaginal epithelium, dryness, and discomfort. Replacing estrogen locally directly to the vaginal mucosa helps rebuild the thickness of the epithelium, increases lubrication, and improves elasticity, which relieves symptoms. A vaginal estrogen cream provides targeted treatment with minimal systemic absorption, making it the most effective local option.

The other agents don’t address the underlying estrogen deficiency: podophyllin is used for genital warts; corticosteroid cream can calm inflammation but does not reverse mucosal atrophy and may thin tissue with use; boric acid is used for certain infections and pH issues, not for treating atrophic changes.