What condition is most likely if a postmenopausal woman exhibits pale and thin vaginal mucosa along with a yellowish discharge?

Atrophic vaginitis is characterized by the thinning and pale appearance of the vaginal mucosa, which is a direct result of decreased estrogen levels following menopause. As estrogen is responsible for maintaining the health and elasticity of vaginal tissues, its deficiency leads to symptoms such as dryness, irritation, and inflammation in the vaginal area.

The presence of a yellowish discharge further supports this diagnosis, as atrophic vaginitis can be associated with changes in vaginal flora and may lead to the overgrowth of certain pathogens due to a less favorable environment for normal flora. This can produce mild discharge, contrasting with the more intense or abnormal discharges seen in infections like candidiasis.

In this scenario, the combination of pale and thin vaginal mucosa along with the yellowish discharge strongly points to atrophic vaginitis as the most likely condition affecting the postmenopausal woman.