Here’s everything you need to know about vaginal atrophy, including what it is, why it happens, and how you can find relief.
If you’ve ever experienced persistent vaginal dryness, irritation, itching, or pain, it could be related to vaginal atrophy.
Vaginal atrophy frequently occurs during perimenopause and menopause, but it can also happen at other stages of your life. The condition can cause discomfort, frustration, and pain in anything from your day-to-day life to intimate moments.
Vaginal atrophy is quite common, but it often goes undiagnosed and untreated. The condition is very treatable, though—there are tons of different options that can help you address symptoms and find relief.
Here’s everything you need to know about vaginal atrophy, including what causes vaginal atrophy, symptoms of vaginal atrophy, and how to treat vaginal atrophy.
What is vaginal atrophy? Vaginal atrophy is a condition that causes vaginal walls to become thinner and cervical mucus secretions to decrease. Thin vaginal walls and loss of vaginal lubrication can have lots of painful and distressing effects on health and wellbeing.
Doctors now also refer to vaginal atrophy as “genitourinary syndrome of menopause,” or GSM. This expanded term provides a more complete picture of the symptoms associated with vaginal atrophy, including vaginal, sexual, and urinary symptoms.
How many people experience vaginal atrophy? Postmenopausal women make up the bulk of vaginal atrophy diagnoses, with 40% to 57% of the postmenopausal population experiencing symptoms.
Still, postmenopause isn’t the only time you may feel signs of vaginal atrophy. Although the term GSM includes the word “menopause,” you can also experience vaginal atrophy and related GSM symptoms before perimenopause and menopause. In fact, some reports suggest that 15% of women experience symptoms of vaginal atrophy premenopause.
However, total numbers may well be higher. Vaginal atrophy symptoms often go unreported for any number of reasons, including due to embarrassment and shame surrounding sexual health, or the misconception that these symptoms are an expected—and therefore unavoidable—part of getting older.
That means that the number of people who experience vaginal atrophy symptoms is likely higher. Some research indicates that around 70% of women with signs of vaginal atrophy don’t discuss their symptoms with their healthcare providers.
What are symptoms of vaginal atrophy? Vaginal atrophy and genitourinary syndrome of menopause (GSM) can cause troubling, uncomfortable, and often painful symptoms ranging from vaginal and sexual to urinary.
Signs and symptoms of vaginal atrophy and GSM include:
Vaginal dryness Vaginal irritation Vaginal burning Vaginal itching Vaginal or pelvic pain or pressure Decreased lubrication Discomfort during sex Pain during sex (dyspareunia) Bleeding during or after sex Painful orgasms (dysorgasmia) Loss of libido Discomfort or pain while peeing (dysuria) Overactive bladder Urinary incontinence (sudden urge to pee, accompanied by a decrease in bladder control) Recurrent urinary tract infections (UTIs) While you may experience any and all of these vaginal atrophy symptoms, some are more common than others. Vaginal dryness, irritation, burning, and itching, as well as decreased lubrication and painful sex are the most frequently reported symptoms of vaginal atrophy.
What causes vaginal atrophy? Vaginal atrophy and GSM are caused by significant drops in estrogen.
Estrogen is an essential part of vaginal health. It helps:
Keep vaginal lining thick Maintain normal blood flow Keep the vagina moist Keep vaginal tissue flexible and elastic When estrogen levels are low, the hormone can’t properly regulate vaginal health. Over time, persistently low estrogen can alter the anatomy and function of the vagina, and impact overall vaginal health.
This link with low estrogen is why people often experience vaginal atrophy in perimenopause and menopause.
During these stages of your life, your body’s production of estrogen (and other reproductive hormones, like progesterone ) decreases significantly. These falling hormone levels can lead to a number of physical and emotional perimenopause and menopause symptoms , including vaginal atrophy and more.
>>MORE: Perimenopause vs. Menopause: What's the Difference?
But perimenopause and menopause aren’t the only causes of low estrogen. It’s entirely possible to experience decreased estrogen levels—and resulting vaginal atrophy—at other points in your life, premenopause.
For example, vaginal atrophy and GSM symptoms may occur due to low estrogen if:
You’re breastfeeding after giving birth You have certain hypothalamic-pituitary disorders You take certain anti-estrogen medications, like those used to treat endometriosis or uterine fibroids You have primary ovarian insufficiency You had your ovaries removed (oophorectomy) You’re undergoing or recently underwent cancer treatment, including chemotherapy or aromatase inhibitors How to treat vaginal atrophy Vaginal atrophy and GSM can lead to distressing, uncomfortable, and even painful symptoms. The good news is, though, the condition isn’t permanent and symptoms are treatable.
Vaginal atrophy treatment includes over-the-counter methods, prescription medications, and natural remedies. These treatments can help you manage symptoms, find relief, and make your day-to-day life and intimate moments much more comfortable.
If you’re experiencing vaginal atrophy symptoms, know that you’re not alone, and that there’s nothing embarrassing or shameful about your body. Above all, you don’t have to suffer in silence.
Over-the-counter treatment Certain vaginal atrophy treatments are available without a prescription.
For some people, these over-the-counter treatment methods may help restore moisture, which may reduce dryness, itching, and discomfort, and make sex more comfortable.
Non-prescription options include:
Vaginal moisturizers Vaginal lubricants Prescription medication Prescription-strength versions of vaginal moisturizers and lubricants are also available, and may offer relief.
In other cases, stronger medication may be necessary.
If over-the-counter and prescription moisturizers or lubricants don’t help and vaginal atrophy symptoms continue to impact your quality of life, hormone replacement therapy (HRT) may be right for you.
HRT administers hormones to supplement and stabilize your body’s hormone levels. There are two main types: estrogen replacement therapy (also called estrogen-only HRT) and combined HRT.
Vaginal estrogen replacement therapy is a form of localized estrogen-only HRT, meaning the estrogen stays in your vagina instead of entering your bloodstream. Side effects and risks are low.
Vaginal estrogen therapy is the recommended treatment for moderate to severe vaginal atrophy symptoms.
This form of HRT administers very low doses of estrogen directly into the vagina using a vaginal:
Vaginal estrogen therapy treats vaginal and sexual symptoms of vaginal atrophy by helping to increase vaginal lubrication, blood flow, and elasticity, thicken vaginal lining, and boost sensation in vaginal tissue. This treatment may also relieve urinary symptoms by preventing recurrent UTIs, overactive bladder, and urinary incontinence.
If you’re treating vaginal atrophy and GSM symptoms only, you’ll likely start with vaginal estrogen replacement therapy on its own.
If you have other troubling perimenopause or menopause symptoms, like hot flashes , you may be prescribed higher doses of HRT, often in systemic forms that circulate throughout your body. (And if you have a uterus, you’ll take combined HRT to more safely supplement both estrogen and progesterone levels.)
Natural remedies Certain lifestyle and diet changes may also be able to help you boost your estrogen levels to relieve vaginal atrophy symptoms.
Natural remedies include:
>>MORE: 7 High-Estrogen Foods to Balance Your Hormones Naturally
Vaginal atrophy: the bottom line Vaginal atrophy, or genitourinary syndrome of menopause (GSM), is a condition caused by low estrogen levels in which the lining of the vaginal walls thins and vaginal lubrication decreases.
While vaginal atrophy most commonly occurs during perimenopause and menopause, people can experience symptoms premenopause, as well.
Vaginal atrophy can be distressing and painful, leading to symptoms like vaginal dryness, irritation, burning, and itching, and discomfort or pain during sex.
Vaginal atrophy is treatable. Options include over-the-counter methods like vaginal moisturizers and lubricants, as well as prescription medications like vaginal estrogen replacement therapy.
If you’re experiencing vaginal atrophy, talk to you doctor about your symptoms. You don’t have to needlessly suffer—together, you and your doctor can work to find treatment options that are right for you.
