Vaginal Atrophy: Symptoms, Causes, Risk Factors, and Treatment

Vaginal atrophy, also called atrophic vaginitis, or genitourinary syndrome of menopause (GSM), is the drying and thinning of the vaginal walls due to low estrogen levels. It is mostly menopausal women that experiences vaginal atrophy. Vaginal atrophy makes intercourse painful and causes urinary problems for most women.

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Symptoms of Vaginal Atrophy

Symptoms may range from moderate to severe. A woman may experience the following vaginal and urinary symptoms:

Causes of Vaginal Atrophy

The major cause of vaginal atrophy is low estrogen production. Low estrogen causes the tissues of your vagina to become drier, thinner, less elastic and more fragile.

Low estrogen levels may occur:

  • During the years leading up to menopause (perimenopause)
  • After menopause
  • After surgical removal of both ovaries
  • After pelvic radiation therapy for cancer
  • After chemotherapy for cancer
  • As a side effect of breast cancer hormonal treatment

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Risk factors

Certain factors may contribute to vaginal atrophy. They include:

  • No vaginal births:Women who have never given birth vaginally are more likely to develop this condition than women who have had vaginal deliveries, according to researchers.
  • Smoking:The vagina and other body tissues may not get enough oxygen due to cigarette smoking because it affects blood circulation. Smoking also reduces the effects of naturally occurring estrogens in your body.
  • No sexual activity.Sexual activity increases blood flow and causes your vaginal tissues to become more elastic.


Vaginal atrophy increases your risk of:

  • Vaginal infections:Changes in the acid balance of your vagina causes vaginal infections (vaginitis) more likely.
  • Urinary problems:Urinary changes linked with vaginal atrophy can contribute to urinary problems causing you to experience an increased frequency or urgency of urination or burning with urination.

When to see a doctor

Though a large majority of postmenopausal women experience vaginal atrophy or genitourinary syndrome of menopause (GSM), only few seek treatment. As a woman, don’t be ashamed to 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, others) or water-based lubricant (Astroglide, K-Y jelly, Sliquid, others).

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Vaginal atrophy or genitourinary syndrome of menopause may be prevented by engaging in frequent sexual activity, with or without a partner. This is because sexual activity increases blood flow to your vagina, which helps keep vaginal tissues healthy.


Diagnosis of vaginal atrophy may involve:

  • Pelvic exam:This involves your doctor feeling your pelvic organs and visually examining your external genitalia, vagina and cervix. Your doctor also checks for signs of pelvic organ prolapse.
  • Urine test:This involves collecting and examining your urine.
  • Acid balance test:This has to do with your doctor taking a sample of vaginal fluids or placing a paper indicator strip in your vagina to test its acid balance.

READ ALSO: Homemade Remedies to Balance Your Vaginal pH


To treat vaginal atrophy, your doctor may first recommend that you:

  • Try a vaginal moisturizer(K-Y Liquibeads, Replens, others) to restore some moisture to your vaginal area. You may have to apply the moisturizer every two to three days. Moisturizer generally last longer than a lubricant.
  • Use a water-based lubricant(Astroglide, K-Y jelly, Sliquid, others) to reduce pain during intercourse. Choose products that don’t contain glycerin because women who are sensitive to this chemical may experience burning and irritation. Avoid petroleum jelly or other petroleum-based products for lubrication if you’re also using condoms. Petroleum can break down latex condoms on contact.

If symptoms persists, your doctor may recommend:

  • Topical (vaginal) estrogen:This controls your general exposure to estrogen because less reaches your bloodstream. It also provide better direct relief of symptoms than oral estrogen.
  • Oral estrogen.Estrogen taken by mouth enters your entire system. Ask your doctor to explain the risks and the benefits of oral estrogen.

Topical estrogen

Vaginal estrogen therapy comes in several forms. Because they all seem to work equally well, you and your doctor can decide which one is best for you.

  • Vaginal estrogen cream: This involves using an applicator to apply the creamdirectly into your vagina at bedtime. Your doctor will let you know how much cream to use and how often to insert it.
  • Vaginal estrogen ring: This involves your doctor inserting a soft, flexible ring into the upper part of the vagina which releases a consistent dose of estrogen while in place and needs to be replaced about every three months.
  • Vaginal estrogen tablet: This is using a disposable applicator to place a vaginal estrogen tablet in your vagina. Your doctor will let you know how often to insert the tablet. You might, for instance, use it daily for the first two weeks and then twice a week thereafter.

Article source: Mayo clinic

Disclaimer: The content provided on is purely informative and educational in nature and should not be interpreted as medical advice. Please use the content only in consultation with an appropriate certified medical doctor or healthcare professional.

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