Vaginal Atrophy
What is Vaginal Atrophy? Changes in the vulvar and vaginal tissues characterized by irritation, dryness and thinning of vaginal tissue.
Learn More About
Why does it happen?
Vaginal atrophy is primarily caused by the lack of estrogen, most common during menopause. Estrogen is a hormone produced by the ovaries that helps maintain the health and lubrication of
the vaginal tissues.
How long does it last?
Unlike other menopause symptoms (hot flashes, night sweats, etc.), vaginal atrophy often persists and may get worse with time.
Estrogen & Vaginal Health
The vaginal lining contains estrogen receptors, which when stimulated by the hormone, keep the walls thick and elastic. When circulating estrogen decreases, the vaginal walls become thinner and drier.
A healthy vagina is normally acidic, but with menopause can become less acidic which leaves women more susceptible to urinary tract infections.
The vulval area also change as fatty tissue reduces and the labia majora (outer lips of the vagina) and skin covering the clitoris may contract. As sensitive areas become more exposed, this can lead to chafing and irritation.
Pelvic floor muscles become weaker and urination may become more frequent and difficult to control.
The Symptoms
- Irritation, burning, itching, chafing or other discomfort.
Dryness due to decreased vaginal secretions which may lead to painful or uncomfortable intercourse. - Inflammation, known as atrophic vaginitis, which can lead to pain with urination and infection.
- Persistent, smelly discharge due decreased vaginal acidity (higher pH). This can sometimes be mistaken for yeast.
Treatment Options
| Treatment Type | How it Helps |
|---|---|
| Lifestyle Changes |
|
| Over the Counter |
|
| Prescription |
|
Lifestyle Changes
- Cool washes or compresses
- can help with irritation and itching. Gently
- pat dry. This can be used multiple times daily.
- Keeping the area clean and dry. If you wear a pad for urine leakage,
make sure to change it regularly as urine can irritate the vulvar and
vaginal tissues.
Over the Counter
- Vaginal moisturizers can help plump and moisturize the vaginal cells. (We recommend ReplensTM or Good Clean LoveTM)
- Vaginal lubricants may reduce friction and make intercourse more enjoyable. Water-based lubricants can be less irritating and are safely used with condoms. Oily based lubricants should not be used with condoms.
- Natural Oils such as avocado and coconut may help soothe. Other oils – such as tea-tree or paw-paw oil can cause dermatitis, increasing discomfort and itching. Hyaluronic acid suppositories can help increase water retention in the vagina leading to increased hydration and elasticity. (We recommend Revaree by BonafideTM and HyaloGyn TM)
Prescription
- Seek medical advice if you have persistent symptoms as it is important to receive a correct diagnosis. Your provider will examine you and take a medical history.
- Vaginal estrogen, in the form of tablets, pessaries or creams, can deliver estrogen directly to the vagina. Vaginal estrogen needs to be inserted regularly in accordance with the instructions, regardless of when you have intercourse. It is only effective when you are using it, so it is important to renew your prescription and have follow-up appointments with your healthcare provider. Progesterone therapy does not need to be used in conjunction with vaginal estrogen.
- Hormone replacement therapy (HRT) – tablets, patches or gels – utilized for menopausal symptoms including vaginal atrophy. If you still have a uterus, it is important to take the estrogen with progestogen (combined therapy) to reduce the risk of developing cancer in the uterus. If you have had a hysterectomy, estrogen therapy alone is sufficient.
Women's Health Topics to Explore
Your health changes throughout every stage of life, and staying informed helps you make the best choices for your body and well-being. This section offers trusted information about women’s health topics—from preventive screenings and menstrual health to menopause and overall wellness. At First Choice OBGYN, our goal is to help you understand your options, support your long-term health, and empower you to take an active role in your care.