Vaginal atrophy is defined as decrease in estrogen production. Less estrogen leads to thinning, drying, and decreased elasticity of the vaginal tissues. PVA is defined as the decrease in estrogen after the menopause. Up to 40 percent of postmenopausal women have symptoms of atrophic vaginitis. In PVA there are symptoms of redness, burning, itching, dryness, irritation, and dyspareunia. HRT, estrogen creams, and other topical preparations are used in the treatment of PVA.