American Nurses Credentialing Center (ANCC) Practice Exam 2026 – Comprehensive All-in-One Guide for Exam Success!

The initial management for a 69-year-old female patient experiencing dyspareunia, accompanied by a pale, dry vagina, focuses on addressing vaginal atrophy, which is common in postmenopausal women due to decreased estrogen levels. The use of a topical hormonal cream is particularly effective because it helps restore estrogen in the vaginal tissues, which enhances moisture, elasticity, and overall vaginal health. This approach directly targets the underlying condition leading to dyspareunia, rather than merely addressing symptoms.

Topical hormonal therapies can significantly improve comfort during intercourse and alleviate symptoms of vaginal dryness. They are often considered the first-line treatment for postmenopausal women presenting with these symptoms, as they tackle the root cause rather than just providing symptomatic relief. Additionally, the recommendation aligns with current clinical guidelines for managing atrophic vaginitis associated with hormonal changes.

Other management strategies, such as lubricants, may provide symptomatic relief but do not address the underlying atrophic changes. Antifungal creams are indicated in cases where a yeast infection is suspected, which is not the case based on the described symptoms. Daily douching is not recommended, as it can disrupt normal vaginal flora and lead to further irritation.