Atrophic vaginitis is prevalent among postmenopausal women; however, it is often underreported and underdiagnosed. The estrogen-related changes to the vaginal epithelium can adversely affect a woman’s quality of life. Although systemic therapy can be of benefit in the treatment of atrophic vaginitis, vaginal estrogen preparations are often recommended. Postmenopausal women may find relief of symptoms of atrophic vaginitis with vaginal estrogen therapies.