Vaginal Atrophy

“Vaginal atrophy (also called atrophic vaginitis) is a condition
where the lining of the vagina gets drier and thinner.
This results in itching, burning and pain during sex…”.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 (also called atrophic vaginitis) is a condition where the lining of the 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 frequent urination. Vaginal refers to the vagina while atrophy means “a wasting away or diminution.” 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 can be accompanied by the effects of low estrogen”.3

Genitourinary Syndrome of Menopause

What is the genitourinary syndrome of menopause (GSM)?

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”.4

In Vaginal Atrophy the (Australian) Jean Hailes for Women’s Health (JH) explain:

Vaginal Atrophy

“Vaginal atrophy occurs when the lining of the vagina becomes dry and thin, leading to problems such as itching, burning, and pain during sex. It is caused by a drop in oestrogen levels around the time of menopause. It’s also common to develop urinary (wee) symptoms including urinary leakage and recurrent urinary tract infections (UTIs). Because the condition causes vaginal, urinary and sexual symptoms, and occurs around or after menopause, vaginal atrophy is also known as genitourinary syndrome of menopause (GSM)”.5

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”.6

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”.7

Treatment

How can VVA be treated?

In Vaginal Dryness: Treatment Options the NAMS 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…”.8

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)”.9

Vaginal Estrogen

Can estrogen be placed directly into the vagina?

On page one in Deciding About Hormone Therapy Use published July 2022, the NAMS 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)”.10

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”.11

Sexual Activity

May regular sexual activity help?

In Vaginal Atrophy: Prevention of Vaginal Atrophy the JH explain:

“Regular sexual activity (with or without a partner) may help prevent vaginal atrophy. Sexual activity improves blood flow to the vagina which helps keep vaginal tissues elastic and flexible. Sexually active women report fewer symptoms of vaginal atrophy compared to women who don’t have regular sex”.12

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 Discomfort: Discomfort Not Directly Related To Menopause the NAMS elaborate on:

“Because vaginal discomfort can arise from so many different sources, persistent symptoms of dryness, irritation, burning, itchiness, or pain should be evaluated by a healthcare provider to determine their cause”.13

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

“Many women experience the symptoms of vaginal atrophy but don’t seek treatment because they feel embarrassed. Others think there is nothing that can be done and that they just have to ‘grin and bear it’. If you experience any of the signs or symptoms mentioned, make an appointment with your doctor because treatment can be very effective. If pain, irritation or other symptoms continue after treatment, please see your doctor to check for another cause”.14

In Vulvovaginal Symptoms After Menopause the Australasian Menopause Society remind us:

  • “Unlike some menopausal symptoms, such as hot flushes, which may disappear as time passes; genito-urinary problems often persist and may progress with time. Genito-urinary symptoms are associated both with menopause and with aging”.15

Health Topics A-Z

Where may I find Health Topics 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. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  2. Caredownthere.com.au
  3. Could Altering Vaginal Microbiome Treat Vaginal Dryness and Painful Sex During Menopause?
  4. Could Chamomile Vaginal Gel Improve the Sexual Function of Postmenopausal Women
  5. Deciding About Hormone Therapy Use
  6. Douching
  7. Dr Gail Busby – I Forgot To Ask the Doctor – Episode 9 The Menopause
  8. Early Treatment of Vulvovaginal Atrophy May Prevent Distressing Symptoms
  9. Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Symptom Severity in Women With Postmenopausal Vaginal Symptoms A Randomized Clinical Trial
  10. Estrogen (Vaginal Route)
  11. Estrogen (Vaginal Route): Description and Brand Names
  12. Experiencing Vaginal Dryness? Here’s What You Need To Know
  13. Find A Menopause Practitioner [United States and Other]
  14. Find An AMS Doctor [Australasian Menopause Society i.e. Australia and New Zealand]
  15. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  16. Hormonally Mediated Vestibulodynia
  17. How Do I Deal With Vaginal Atrophy? — Ask Dr Jean
  18. International Society for the Study of Vulvovaginal Diseases: Patient Handouts
  19. International Society for the Study of Women’s Sexual Health: Find A Provider
  20. 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
  21. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Sexual Wellbeing and Intimacy During and After Menopause [+ Video: Menopause Is the End of Your Sex Life]
  22. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Signs and Symptoms [+ Video: Talking Menopause With Your GP]
  23. 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]
  24. Let’s Talk About Perimenopause
  25. Lubricant Alternatives: What To Use and What To Avoid
  26. Managing Postmenopausal Vaginal Atrophy
  27. Managing Your Symptoms: Managing Bladder, Vaginal and Vulval Problems
  28. Mayo Clinic Q and A: Managing Vaginal Dryness
  29. Menopause
  30. Menopause
  31. Menopause
  32. Menopause
  33. Menopause Explained – A British Menopause Society Video
  34. Menopause FAQs: Understanding the Symptoms – Q. How can I counteract vaginal dryness during menopause?
  35. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
    Vaginal Atrophy
  36. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Symptom Tracker
  37. Menopause Mindfulness: Embracing the Change of My Midlife
  38. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  39. Menopause Patient Information [Videos] 4. The Different Types of HRT
  40. Menopause Preparedness Toolkit Video Series: Common Conditions Associated With Menopause and Midlife
  41. Menopause Preparedness Toolkit: A Woman’s Empowerment Guide
  42. Menopause Ruining Your Sex Life?
  43. Menopause Signs and Symptoms
  44. Menopause Treatments: What Works, What Doesn’t – Treatments for Vaginal Dryness
  45. Menopause What Are the Symptoms?
  46. Menopause and Sex – Fact Sheet
  47. Menopause – Information for Partners – Fact Sheet
  48. Menopause: Diagnosis and Management – Information for the Public: Questions To Ask About Menopause [NICE Guideline]
  49. Mona Lisa Touch – Ask Dr Jean
  50. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  51. National Center for Complementary and Integrative Health: Menopausal Symptoms: In Depth
  52. Navigating Menopause Together: How Partners Can Help
  53. Navigating Menopause: Expert Insights and Solutions | Dr Susan Davis | The Proof Podcast EP 245
  54. Patty Brisben Foundation for Women’s Sexual Health
  55. Patty Brisben Foundation for Women’s Sexual Health: Guide To Sexual Health Providers
  56. Perimenopause
  57. Perimenopause
  58. Perimenopause and Menopause Symptom Checklist
    Perimenopause Symptom Checklist
  59. Perimenopause – Fact Sheet
  60. Prosayla.com [Prosayla Supported by the ISSWSH [International Society for the Study of Women’s Sexual Health]]
  61. Severe Postmenopausal Symptoms Decrease Quality of Life, But Can Be Treated
  62. Sex and Menopause: Treatment for Symptoms
  63. Supporting A Loved One Through Menopause
  64. Symptoms of Menopause: Bladder, Vaginal & Vulval Problems
  65. The 2020 Genitourinary Syndrome of Menopause Position Statement of The North American Menopause Society
  66. The Burden of Vulvovaginal Atrophy on Women’s Daily Living: Implications on Quality of Life From A Face-To-Face Real-Life Survey
  67. The Genitourinary Syndrome of Menopause: An Overview of the Recent Data
  68. The Use of Vaginal Estrogen In Women With A History of Estrogen-Dependent Breast Cancer
  69. The Vaginal Laser Therapy versus Vaginal Estrogen Therapy: The VeLVET Trial [Video]
  70. Tips To Help Manage Menopause Symptoms
  71. Topical Estrogens and Non-Hormonal Preparations for Postmenopausal Vulvovaginal Atrophy: An EMAS Clinical Guide
  72. Urogenital Atrophy Explained – A British Menopause Society Video
  73. Using Natural Therapies In the Menopause Transition – Webinar
  74. Vaginal & Vulval Pain: Know the Different Causes and When To Seek Help
  75. Vaginal Atrophy
  76. Vaginal Atrophy
  77. Vaginal Atrophy
  78. Vaginal Dryness
  79. Vaginal Dryness
  80. Vaginal Dryness
  81. Vaginal Dryness
  82. Vaginal Dryness
  83. Vaginal Dryness After Menopause: How To Treat It? I’m postmenopausal and often have vaginal dryness, which makes intercourse painful. Is there anything I can do about it?
  84. Vaginal Dryness: Alternative Treatments
  85. Vaginal Laser Therapy
  86. Video Series-2021: Common Issues Surrounding Sexuality and Menopause
  87. Video Series-2021: Treatment Options for Vaginal Dryness and Urinary Issues
  88. Video Series-2022: Discussing Sexual Health Concerns With Your Health Care Professional
  89. Video Series-2022: Hormone Therapy: Understanding the Risks and Benefits
  90. Video Series-2022: Perimenopause, Signs, Symptoms, and Solutions
  91. Videos and Podcasts: Videos – Interviews: Vulvovaginal Atrophy
  92. Vulva & Vaginal Irritation [+ Video]
  93. Vulvovaginal Atrophy
  94. Vulvovaginal Health
  95. Webinars: Previous – VVA – The Silent Epidemic [Vulvovaginal Atrophy]
  96. What Everyone Should Know About Menopause Symptoms
  97. What Is Menopause?
  98. What Is Vaginal Steaming and Is It Safe?
  99. Why Didn’t Anyone Tell Me This? Episode 3: Dr Annice Mukherjee: Your Essential Menopause Toolkit
  100. Wild Yam

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: 27 October 2020. Cleveland Clinic https://my.clevelandclinic.org/health/diseases/15500-vaginal-atrophy Accessed: 12 January 2023
  2. Vaginal Atrophy: Symptoms & Causes – Overview. 17 September 2021. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288 Accessed: 12 January 2023
  3. Vaginal Atrophy: Overview – What Is Vaginal Atrophy? Last Updated: 27 October 2020. Cleveland Clinic https://my.clevelandclinic.org/health/diseases/15500-vaginal-atrophy Accessed: 12 January 2023
  4. 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: 12 January 2023
  5. Vaginal Atrophy. Last Updated: 01 September 2022. Last Reviewed: 15 October 2021. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina-ovaries-uterus/vulval-vaginal-conditions/vaginal-atrophy Accessed: 12 January 2023
  6. Vulvovaginal Atrophy. 2022 European Menopause and Andropause Society https://emas-online.org/wp-content/uploads/2022/07/Vulvovaginal-atrophy.pdf Accessed: 12 January 2023
  7. Vaginal Atrophy: Symptoms & Causes – Causes. 17 September 2021. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288 Accessed: 12 January 2023
  8. Vaginal Dryness: Treatment Options. 2022: 1-2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 12 January 2023
  9. 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: 12 January 2023
  10. Deciding About Hormone Therapy Use. 2022:1. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 12 January 2023
  11. 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: 12 January 2023
  12. Vaginal Atrophy: Prevention of Vaginal Atrophy. Last Updated: 01 September 2022. Last Reviewed: 15 October 2021. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina-ovaries-uterus/vulval-vaginal-conditions/vaginal-atrophy Accessed: 12 January 2023
  13. Vaginal Discomfort: Discomfort Not Directly Related To Menopause. North American Menopause Society https://www.menopause.org/for-women/sexual-health-menopause-online/causes-of-sexual-problems/vaginal-discomfort Accessed: 12 January 2023
  14. Vaginal Atrophy: When To See Your Doctor. Last Updated: 01 September 2022. Last Reviewed: 15 October 2021. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/vulva-vagina-ovaries-uterus/vulval-vaginal-conditions/vaginal-atrophy Accessed: 12 January 2023
  15. Vulvovaginal Symptoms After Menopause. Content Created September 2018. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/376-vulvovaginal-symptoms-after-menopause Accessed: 12 January 2023
Topic Last Updated: 31 March 2023 – Topic Last Reviewed: 12 January 2023

Print Friendly, PDF & Email
/by