How can one tell the difference between vaginal atrophy and interstitial cystitis? are there any big differences in symptoms that stand out?

The symptoms usually are quite different. IC mimics UTI, typically with urinary urgency (“Gotta go right now!), frequency with small amounts of urine, painful urination, sometimes visible blood in urine. Vaginal atrophy may cause no symptoms except painful intercourse, sometimes vulvar irritation, itching. Atrophy isn’t very common at your age. Discuss with your gynecologist. Good luck.

The first is a shrinkage of the external genitalia and often some urinary symptoms, no pain commonly due to hormonal changes of aging. The second is a condition of the bladder with, urgency, marked frequency and pain and happens in younger women