What medication is recommended to treat the symptoms of atrophic vaginitis in postmenopausal patients?

Topical estrogen cream, such as Estrace, is recommended for treating the symptoms of atrophic vaginitis in postmenopausal patients due to its direct action on the vaginal tissues. Atrophic vaginitis occurs as a result of decreased estrogen levels after menopause, leading to thinning and inflammation of the vaginal epithelium. Symptoms often include vaginal dryness, irritation, and discomfort during intercourse.

Topical estrogen therapy is effective because it helps to restore hormonal balance locally, promoting the proliferation of vaginal epithelial cells, increasing vaginal lubrication, and alleviating the associated symptoms. By administering estrogen locally in the form of a cream, it minimizes systemic effects while effectively addressing the specific vaginal atrophy.

Other options, while they may treat different conditions, do not address the root cause of atrophic vaginitis. Topical hydrocortisone is mainly used for inflammatory skin conditions and would not effectively treat the hormonal deficiency causing atrophy. Metronidazole vaginal gel is an antibiotic effective against bacterial vaginosis but does not provide relief for menopausal symptoms. Terconazole is used for antifungal treatment of vaginal yeast infections and also does not target the hormonal changes that result in atrophic vaginitis. Thus, topical estrogen remains the most appropriate choice for symptom relief