“Vaginal atrophy is a condition where the lining of your
vagina gets drier and thinner. This results in itching,
burning and pain during sex, among other symptoms”.1

Umbrella

What may the Vaginal Atrophy Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Atrophic Vaginitis
  • Genital Atrophy
  • Genitourinary Syndrome of Menopause (GSM)
  • Urogenital Problems
  • Vaginal Atrophy
  • Vaginal Discomfort
  • Vaginal Dryness
  • Vaginal Symptoms
  • Vulvovaginal Atrophy (VVA)

Definition

What is vaginal atrophy?

DotS the definition of vaginal atrophy may vary. The (United States) Mayo Clinic’s definition is:

“Vaginal atrophy (atrophic vaginitis) is thinning, drying and inflammation of the vaginal walls that may occur when your body has less estrogen. Vaginal atrophy occurs most often after menopause”.2

The (United States) Cleveland Clinic’s definition is:

“Vaginal atrophy is a condition where the lining of your vagina gets drier and thinner. This results in itching, burning and pain during sex, among other symptoms. The condition also includes urinary tract problems such as urinary tract infections (UTIs) and urinary incontinence”.3

The (Australian) Jean Hailes for Women’s Health (JH) definition is:

“Vulvovaginal atrophy is the thinning of your vaginal lining and vulval skin, caused by a drop in oestrogen levels around the time of menopause”.4

Genitourinary Syndrome of Menopause

What is the genitourinary syndrome of menopause (GSM)?

DotS the definition of vaginal atrophy may vary. In Vaginal Atrophy: Overview – What Is Vaginal Atrophy? the Cleveland Clinic note:

“Recently, the term vaginal atrophy has been replaced with the newer term, genitourinary syndrome of menopause (GSM). This new term helps describe not just the vaginal, but also the urinary symptoms that may occur as a result of low estrogen”.5

In Vaginal Atrophy: Overview the Mayo Clinic explain:

“For many women, vaginal atrophy not only makes intercourse painful but also leads to distressing urinary symptoms. Because the condition causes both vaginal and urinary symptoms, doctors use the term “genitourinary syndrome of menopause (GSM)” to describe vaginal atrophy and its accompanying symptoms”.6

Common or Not

How common is vaginal atrophy?

In Vulvovaginal Atrophy: What Is Vulvovaginal Atrophy? the JH note:

Vaginal Atrophy“Vaginal atrophy affects about 40% of postmenopausal women – and the risk increases with age”.7

In Vaginal Atrophy: Overview – How Common Is Vaginal Atrophy? (GSM) the Cleveland Clinic note:

“At least half of women and people AFAB who enter menopause show signs and symptoms of genitourinary syndrome of menopause. Vaginal dryness is typically the first indication that a person is developing vaginal atrophy”.8

Symptoms

What may be symptoms of vaginal atrophy?

In Vulvovaginal Atrophy the European Menopause and Andropause Society explain:

Vaginal Atrophy“Symptoms include:

  • Irritation
  • Burning
  • Itching
  • Chafing
  • Discomfort
  • Uncomfortable or even painful intercourse
  • Passing urine more frequently
  • More frequent urinary tract infections
  • Greater discomfort with cervical smear tests”.9

Cause

What causes vaginal atrophy?

In Vaginal Atrophy: Symptoms & Causes – Causes the Mayo Clinic elaborate on:

“Genitourinary syndrome of menopause is caused by a decrease in estrogen production. Less estrogen makes your vaginal tissues thinner, drier, less elastic and more fragile”.10

Treatment

How can VVA be treated?

In Vaginal Atrophy: Can Vaginal Atrophy Be Reversed? the JH note:

“You can’t reverse vulvovaginal atrophy, but you can stop it from getting worse by seeking a diagnosis and starting treatment early. Research suggests that MHT eliminates vulvovaginal atrophy symptoms in 75% of cases, while vaginal oestrogen therapy is effective in 80% to 90% of cases. Without treatment, vulvovaginal atrophy may get worse over time”.11

On page one and two in Genitourinary Syndrome of Menopause: Treatment Options, published 2025, the (United States) Menopause Society, (formerly the North American Menopause Society) elaborate on:

“There are many effective treatment options for GSM, including over-the-counter and prescription therapies. Therapies for less severe symptoms include nonhormone over-the-counter lubricants used as needed for sexual activity and moisturizers used regularly (several times per week) to maintain moisture. Prescription therapies include low-dose vaginal estrogens, vaginal dehydroepiandrosterone inserts, and oral ospemifene. Nonhormone lubricants and moisturizers can be used in combination with prescription therapies for more severe symptoms.

  • Nonhormone Remedies
    • Vaginal Lubricants…
    • Vaginal Moisturizers…
    • Regular Sexual Stimulation…
    • Expanding Your Views of Sexual Pleasure…
    • Vaginal Dilators…
    • Pelvic Floor Exercises…
  • Vaginal Hormone Therapy…
    • An effective and safe treatment, low-dose local estrogen applied directly to the vulva and vagina relieves vulvar and vaginal discomfort, irritation, dryness, or pain with sexual activity…
    • FDA-approved low-dose vaginal estrogen products…
    • Dehydroepiandrosterone (DHEA; Prasterone)
    • Low-dose vaginal estrogen or DHEA may be options for…
  • Systemic Estrogen Therapy
  • Other Therapies…
    • Ospemifene
    • Vaginal Laser Therapy…”.12

The Mayo Clinic also note:

“… make an appointment to see your doctor if you experience painful intercourse that’s not resolved by using a vaginal moisturizer (K-Y Liquibeads, Replens, Sliquid, others) or water-based lubricant (Astroglide, K-Y Jelly, Sliquid, others)”.13

Vaginal Estrogen

Can estrogen be placed directly into the vagina?

On page one in Deciding About Hormone Therapy Use published 2025, the Menopause Society explain:

“If you are bothered only by vaginal dryness, you can use very low doses of estrogen placed directly into the vagina. These low doses generally do not raise blood estrogen levels above postmenopause levels and do not treat hot flashes. You do not need to take a progestogen when using only low doses of estrogen in the vagina”.14

On page three in the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause first published online 10 June 2022, one of the recommendations is:

  • “Low-dose and ultra-low dose vaginal oestrogen preparations can be taken by perimenopausal and menopausal women experiencing genitourinary symptoms and continued for as long as required. All vaginal oestrogen preparations have been shown to be effective in this context and there is no requirement to combine vaginal oestrogens with systemic progestogen treatment for endometrial protection, as low-dose and ultra-low dose vaginal oestrogen preparations do not result in significant systemic absorption or endometrial hyperplasia”.15

In The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Local Treatment of Urogenital Atrophy published December 2023, the authors note:

“Urogenital symptoms due to estrogen insufficiency are under-recognized and under-treated. These symptoms can be effectively treated with an array of local therapies including intravaginal estrogen preparations or DHEA (prasterone) and intravaginal moisturizers. Concurrent progestogen therapy is not required. Many women require local therapy, in addition to systemic MHT, to relieve urogenital symptoms. It is important patients understand that treatment needs to be ongoing and is not simply a short course of therapy”.16

Sexual Activity

May regular sexual activity help?

In Vaginal Atrophy: What You Can Do About Vulvovaginal Atrophy – Regular Sexual Activity Including Masturbation the JH explain:

  • “Regular sexual activity improves blood flow to your vagina, which can keep vaginal tissues elastic and flexible. Sexually active women report fewer symptoms of vulvovaginal atrophy compared to women who don’t have regular sex”.17

Health Care Provider

What if I think I have vaginal atrophy?

If you think you have vaginal atrophy, it may be in your best interest to choose to talk to your health care provider about this.

In Vaginal Atrophy: When To See Your Doctor the JH note:

“Many women have symptoms of vulvovaginal atrophy, such as painful sex, but they don’t seek treatment because they feel embarrassed or think nothing can be done. It’s important to get the right diagnosis and treatment, so see your doctor if you have any symptoms”.18

Health Topics A-Z

Where may I find Health Topics A-Z related to the Vaginal Atrophy?

In Health Topics A-Z you may find:

Links

Where may I find Links related to Vaginal Atrophy?

Your Country may have Links similar to:

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Vaginal Atrophy: Overview – What Is Vaginal Atrophy? Last Updated: 10 April 2023. Cleveland Clinic https://my.clevelandclinic.org/health/diseases/15500-vaginal-atrophy Accessed: 27 August 2025
  2. Vaginal Atrophy: Symptoms & Causes – Overview. 17 September 2021. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288 Accessed: 27 August 2025
  3. Vaginal Atrophy: Overview – What Is Vaginal Atrophy? Last Updated: 10 April 2023. Cleveland Clinic https://my.clevelandclinic.org/health/diseases/15500-vaginal-atrophy Accessed: 27 August 2025
  4. Vulvovaginal Atrophy: What Is Vulvovaginal Atrophy? Last Updated: 15 August 2025. Last Reviewed: 02 June 2025. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina/vulval-vaginal-conditions/vaginal-atrophy Accessed: 27 August 2025
  5. Vaginal Atrophy: Overview – What Is Vaginal Atrophy? Last Updated: 10 April 2023. Cleveland Clinic https://my.clevelandclinic.org/health/diseases/15500-vaginal-atrophy Accessed: 27 August 2025
  6. Vaginal Atrophy: Symptoms & Causes – Symptoms: When To See A Doctor. 17 September 2021. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288 Accessed: 27 August 2025
  7. Vulvovaginal Atrophy: What Is Vulvovaginal Atrophy? Last Updated: 15 August 2025. Last Reviewed: 02 June 2025. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina/vulval-vaginal-conditions/vaginal-atrophy Accessed: 27 August 2025
  8. Vaginal Atrophy: Overview – How Common Is Vaginal Atrophy (GSM)? Last Updated: 10 April 2023. Cleveland Clinic https://my.clevelandclinic.org/health/diseases/15500-vaginal-atrophy Accessed: 27 August 2025
  9. Vulvovaginal Atrophy. 2022 European Menopause and Andropause Society https://emas-online.org/wp-content/uploads/2022/07/Vulvovaginal-atrophy.pdf Accessed: 27 August 2025
  10. Vaginal Atrophy: Symptoms & Causes – Causes. 17 September 2021. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288 Accessed: 27 August 2025
  11. Vulvovaginal Atrophy: Can You Reverse Vaginal Atrophy? Last Updated: 15 August 2025. Last Reviewed: 02 June 2025. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina/vulval-vaginal-conditions/vaginal-atrophy Accessed: 27 August 2025
  12. Genitourinary Syndrome of Menopause: Treatment Options. 2025:1-2. Menopause Society https://menopause.org/wp-content/uploads/for-women/MenoNote-GSM.pdf Accessed: 27 August 2025
  13. Vaginal Atrophy: Symptoms & Causes – Symptoms: When To See A Doctor. 17 September 2021. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288 Accessed: 27 August 2025
  14. Deciding About Hormone Therapy Use. 2025:1. The Menopause Society https://menopause.org/wp-content/uploads/default-document-library/MenoNote-Deciding-About-HT-2025.pdf Accessed: 27 August 2025
  15. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayesena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022 https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 27 August 2025
  16. Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., and Islam, R. M. The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Local Treatment of Urogenital Atrophy. Published Online: 01 December 2023 https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783 Accessed: 27 August 2025
  17. Vaginal Atrophy: What You Can Do About Vulvovaginal Atrophy – Regular Sexual Activity Including Masturbation. Last Updated: 15 August 2025. Last Reviewed: 02 June 2025. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina/vulval-vaginal-conditions/vaginal-atrophy Accessed: 27 August 2025
  18. Vulvovaginal Atrophy: When To See Your Doctor. Last Updated: 15 August 2025. Last Reviewed: 02 June 2025. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina/vulval-vaginal-conditions/vaginal-atrophy Accessed: 27 August 2025
Topic Last Updated: 27 August 2025 – Topic Last Reviewed: 27 August 2025