Vaginal Atrophy

“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:

“Vaginal atrophy (or vulvovaginal atrophy) is the thinning of your vaginal lining and vulval skin, caused by a drop in oestrogen levels around the time of menopause. Reduced oestrogen levels also affect the tissues of the bladder, urethra (where wee comes out) and pelvic floor muscles”.4

Genitourinary Syndrome of Menopause

What is the genitourinary syndrome of menopause (GSM)?

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

On page one and two in Vaginal Dryness: Treatment Options the Menopause Society (formerly The North American Menopause Society) elaborate on:

  • “Nonhormone Remedies
    • Vaginal Lubricants…
    • Vaginal Moisturizers…
    • Regular Sexual Stimulation…
    • Expanding Your Views of Sexual Pleasure…
    • Vaginal Dilators…
    • Pelvic Floor Exercises…
  • Vaginal Hormone Therapy…
    • Low-dose local estrogen…
    • FDA-approved low-dose vaginal estrogen products…
    • Dehydroepiandrosterone (DHEA; Prasterone)
    • Low-dose vaginal estrogen or DHEA and a history breast or uterine cancer…
  • 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 July 2022, 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. (The MenoNote “Vaginal Dryness” covers this topic in detail)”.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 the JH explain:

  • “Regular sexual activity (including masturbation) – to improve blood flow to your vagina, which can keep vaginal tissues elastic and flexible. Sexually active women report fewer symptoms of vaginal 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 vaginal 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:

Health Topics A-Z

Links

Where may I find Links related to Vaginal Atrophy?

Your Country may have Links similar to:

Links

This Links List to third party websites is neither comprehensive nor exhaustive. Inclusion on this Links List does not imply endorsement or recommendation. Non-inclusion on this Links List does not imply non-endorsement or non-recommendation. Third party websites are not under the control of Meno Martha International Menopause Directory. Third party websites may contain explicit medical images and/or sexual references. Please read Meno Martha International Menopause Directory’s Links Policy before proceeding to a Link. Please contact Webmaster if you experience a problem with a Link.

New or Updated

  1. ACOG Explains: Managing Menopause Symptoms [American College of Obstetricians and Gynecologists]
  2. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  3. BMS TV: Urogenital Atrophy
  4. Consumer Video and Podcast Series: 2024 Consumer Videos and Podcasts – Preparing for Your Menopause Health Care Visit
  5. Caredownthere.com.au
  6. Could Chamomile Vaginal Gel Improve the Sexual Function of Postmenopausal Women
  7. Deciding About Hormone Therapy Use
  8. Douching
  9. Estradiol (Vaginal Route)
  10. Estradiol (Vaginal Route): Brand Name US
  11. Experts Answer Your Menopause Questions In New Video
  12. Experiencing Vaginal Dryness? Here’s What You Need To Know
  13. FAQs: Vulvovaginal Health
  14. Find A Menopause Practitioner [United States and Other]
  15. Find An AMS Member [Australasian Menopause Society i.e. Australia and New Zealand]
  16. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  17. Gaslighting of Genitourinary Symptoms of the Menopause
  18. Genitourinary Syndrome of Menopause
  19. Genitourinary Syndrome of Menopause [Video]
  20. Genitourinary Syndrome of Menopause and the False Promise of Vaginal Laser Therapy
  21. Hormone Replacement Therapy (HRT): Vaginal Oestrogen
  22. Hormone Replacement Therapy (HRT): Vaginal Oestrogen: About Vaginal Oestrogen
  23. Hormone Replacement Therapy (HRT): Vaginal Oestrogen: Common Questions About Vaginal Oestrogen
  24. Hormone Replacement Therapy (HRT): Vaginal Oestrogen: Side Effects of Vaginal Estrogen
  25. How To Talk To Your Doctor About Painful Sex
    Vaginal Atrophy
  26. International Society for the Study of Vulvovaginal Diseases: Patient Handouts
  27. International Society for the Study of Women’s Sexual Health: Find A Provider
  28. 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
  29. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Sexual Wellbeing, Intimacy and Menopause [+ Video: Menopause Is the End of Your Sex Life]
  30. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Signs and Symptoms of Menopause [+ Video: Talking Menopause With Your GP]
  31. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Supporting Someone Through the Menopause [+ Video: Men Don’t Need To Know About Menopause]
  32. Let’s Talk About Perimenopause
  33. Lubricant Alternatives: What To Use and What To Avoid
  34. Management of Perimenopausal and Menopausal Symptoms
  35. Managing Your Symptoms: Managing Bladder, Vaginal and Vulval Problems
  36. Mayo Clinic Q and A: Perimenopause Transitions and Concerns
  37. Menopause
  38. Menopause
  39. Menopause Checklist Podcast: Episode 6: Hello Lubricant!
  40. Menopause Hormone Therapy and Urinary Symptoms: A Systematic Review [Video]
  41. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
    Vaginal Atrophy
  42. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Symptom Tracker
  43. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  44. Menopause Patient Information [Videos] 4. The Different Types of HRT
  45. Menopause Preparedness Toolkit Video Series: Common Conditions Associated With Menopause and Midlife
  46. Menopause Ruining Your Sex Life?
  47. Menopause Signs and Symptoms
  48. Menopause Symptoms: Mayo Clinic Expert Outlines Hormone and Nonhormonal Therapies
  49. Menopause Treatments: What Works, What Doesn’t – Treatments for Vaginal Dryness
  50. Menopause: Identification and Management [NICE Guideline Published: 12 November 2015 Last Updated: 07 November 2024]
    Genitourinary Syndrome of Menopause
  51. Menopause: Identification and Management: NICE Guideline [NG23] Published: 12 November 2015 Last Updated: 07 November 2024
  52. Menopause: Things You Can Do
  53. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  54. National Center for Complementary and Integrative Health: Herbs At A Glance
  55. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  56. Navigating Menopause Together: How Partners Can Help
  57. Navigating Menopause: Expert Insights and Solutions | Dr Susan Davis | The Proof Podcast EP 245
  58. Perimenopause
    Vaginal Atrophy
  59. Perimenopause
  60. Perimenopause and Menopause Checklist: Translated Checklists
  61. Perimenopause and Menopause Symptom Checklist
    Vaginal Atrophy
  62. Prosayla.com [Prosayla Supported By the ISSWSH [International Society for the Study of Women’s Sexual Health]]
  63. Sexual Health
  64. Sexual Problems and Menopause
  65. Supporting A Loved One Through Menopause
  66. Symptoms of Menopause: Bladder, Vaginal and Vulval Problems
  67. The Truth About Menopause Supplements | Dr Sarah Berry
  68. Tips To Help Manage Menopause Symptoms
  69. Using Natural Therapies In the Menopause Transition – Webinar
  70. Vaginal Atrophy
  71. Vaginal Atrophy
  72. Vaginal Atrophy
  73. Vaginal and Vulval Pain: Know the Different Causes and When To Seek Help
  74. Vaginal Dryness
  75. Vaginal Dryness
  76. Vaginal Dryness
  77. Vaginal Dryness
  78. Vaginal Dryness After Menopause: Since going through menopause, I often have vaginal dryness. The dryness makes having sex painful. Is there anything I can do about it? [14 May 2024]
  79. Vaginal Dryness Alternative Treatments
  80. ‘Vaginal Dryness’ Can Be Fatal. No, Really.
  81. Vaginal Dryness: What To Do About It
  82. Vaginal Laser Therapy for GSM/VVA: Where We Stand Now – A Review By the EUGA Working Group on Laser
  83. Vaginal Oestrogen Is A Treatment on the Rise, But Is It Safe?
  84. Videos & Podcasts: Videos – Menopause and Hormone Therapy: Current Perspectives and Controversies
  85. Videos and Podcasts: Videos – Vulvovaginal Atrophy
  86. Vulval Irritation [+ Video]
  87. Vulval and Vaginal Conditions: Vaginal Atrophy
  88. Vulvovaginal Atrophy
  89. Webinars: Previous – Pay Attention on Your Way In! The Vulva Is An Important Organ Too
  90. What Everyone Should Know About Menopause Symptoms [Video]
  91. What Happens To Your Vagina As You Age?
  92. What Is Menopause? [+ Video]
  93. What Is the Difference Between Vagifem and Estring?
  94. What Types of Vaginal Oestrogens Are There? [Video]
  95. When Does Perimenopause Start and How Do You Define the Beginning
  96. Which Vaginal Moisturiser Should You Use? [Video]
  97. Wild Yam
  98. World Menopause Day 2024: Leaflet for Women [Multiply Languages]
    Vaginal Atrophy
  99. Leaflet for Women – Menopause and Menopause Hormone Therapy [Multiply Languages]Vaginal Atrophy
  100. World Menopause Day 2024: Poster for Women – The 5 Ws of Menopause Hormone Therapy (MHT)

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: 07 March 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: 07 March 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: 07 March 2025
  4. Vaginal Atrophy. Last Updated: 07 December 2023. Last Reviewed: 26 April 2023. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina/vulval-vaginal-conditions/vaginal-atrophy Accessed: 07 March 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: 07 March 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: 07 March 2025
  7. Vaginal Atrophy: What Is Vaginal Atrophy? Last Updated: 07 December 2023. Last Reviewed: 26 April 2023. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina/vulval-vaginal-conditions/vaginal-atrophy Accessed: 07 March 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: 07 March 2025
  9. Vulvovaginal Atrophy. 2022 European Menopause and Andropause Society https://emas-online.org/wp-content/uploads/2022/07/Vulvovaginal-atrophy.pdf Accessed: 07 March 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: 07 March 2025
  11. Vaginal Atrophy: Can Vaginal Atrophy Be Reversed? Last Updated: 07 December 2023. Last Reviewed: 26 April 2023. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina/vulval-vaginal-conditions/vaginal-atrophy Accessed: 07 March 2025
  12. Vaginal Dryness: Treatment Options. 2022: 1-2. The Menopause Society https://menopause.org/wp-content/uploads/for-women/mn-vaginal-dryness_4e454569-8d3c-4346-a00b-515f46b378c9.pdf Accessed: 07 March 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: 07 March 2025
  14. Deciding About Hormone Therapy Use. 2022:1. The Menopause Society https://menopause.org/wp-content/uploads/for-women/mn-vaginal-dryness_4e454569-8d3c-4346-a00b-515f46b378c9.pdf Accessed: 07 March 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: 07 March 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: 07 March 2025
  17. Vaginal Atrophy: What You Can Do. Last Updated: 07 December 2023. Last Reviewed: 26 April 2023. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina/vulval-vaginal-conditions/vaginal-atrophy Accessed: 07 March 2025
  18. Vaginal Atrophy: When To See Your Doctor. Last Updated: 07 December 2023. Last Reviewed: 26 April 2023. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina-ovaries-uterus/vulval-vaginal-conditions/vaginal-atrophy Accessed: 07 March 2025
Topic Last Updated: 06 April 2025 – Topic Last Reviewed: 07 March 2025

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