Background: Lack of estrogen after menopause can cause many changes in the lower genital tract of women, including involution of the introitus and collapse of the vestibule into the genital cleft.
Cases: Six cases of hypoestrogenic women are described, with the unusual finding of entrapment of terminal hairs between agglutinated genital folds or in the vagina. In symptomatic cases, there were severe inflammatory changes accompanying these findings. The initial case prompted a lengthy and costly diagnostic process to no avail. A MEDLINE search yielded several cases of pilonidal disease of the clitoris in younger women, but no reports of hair in the vagina of postmenopausal women.
Conclusions: This report is noteworthy because pilonidal disease in the lower genital tract of postmenopausal women is a less-known clinical entity. A hypothesis is offered based on its clinical similarity to pilonidal disease in the presacral area.