title: Severe atrophic vaginitis causing vaginal synechiae and hematocolpos at menopause.
abstract: OBJECTIVE
  Vaginal atrophy caused by decreased levels of ovarian estrogen production is common at menopause. Atrophic vaginitis severe enough to result in vaginal stricture of the upper two thirds of the vagina and subsequent hematocolpos is unusual.
  
  
  METHODS
  A 53-year-old woman presented with nonvisualization of the cervix at the time of her annual examination.
  
  
  RESULTS
  Pelvic ultrasound reported a "vaginal cyst," and the final diagnosis of hematocolpos was made by magnetic resonance imaging. The woman was managed with surgical excision of vaginal synechiae followed by local vaginal estrogen therapy and dilators, with satisfactory results.
  
  
  CONCLUSIONS
  Untreated severe atrophic vaginitis at menopause can result in a shortened vagina and hematocolpos. Magnetic resonance imaging is useful to characterize vaginal pathology in postmenopausal women.
authors.affiliation: Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA. saya.segal@uphs.upenn.edu
authors.forename: Saya
authors.initials: S
authors.lastname: Segal
authors.forename: Heidi S
authors.initials: HS
authors.lastname: Harvie
authors.forename: Evan
authors.initials: E
authors.lastname: Siegelman
authors.forename: Lily A
authors.initials: LA
authors.lastname: Arya
mesh_terms: D001284:Atrophy; D005260:Female; D006175:Gynatresia / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006399:Hematocolpos / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008593:Menopause; D008875:Middle Aged; D014463:Ultrasonography; D014621:Vagina / Q000473:pathology*; D014627:Vaginitis / Q000150:complications*