Vaginal Atrophy – Symptoms and Causes

ByJanis Updated

What to Know About Vaginal Atrophy

Vaginal atrophy happens when vaginal walls become thin, dry, and inflamed due to lower estrogen levels, typically after menopause. This condition, also called genitourinary syndrome of menopause (GSM), can cause both vaginal discomfort and urinary problems.

Many women experience pain during sex and troublesome urinary symptoms. The good news is that effective treatments exist for this condition. These options can help manage symptoms and improve quality of life.

Several treatment approaches are available:

  • Hormone therapy (local or systemic)
  • Moisturizers and lubricants for daily comfort
  • Lifestyle modifications to reduce symptoms
  • Prescription medications designed specifically for GSM

You don’t need to accept the discomfort of vaginal atrophy as inevitable, despite dropping estrogen levels changing your body. Medical help can make a significant difference.

Symptoms

Genitourinary syndrome of menopause (GSM) involves several uncomfortable symptoms affecting the vaginal and urinary systems. Common signs include:

Vaginal Symptoms:

  • Dryness and burning sensation
  • Discharge and itching
  • Discomfort during intercourse
  • Reduced lubrication
  • Light bleeding after sexual activity
  • Structural changes (shortening and tightening)

Urinary Symptoms:

  • Burning sensation while urinating
  • Frequent and urgent urination
  • Recurring urinary tract infections
  • Problems with bladder control

When to Talk to Your Doctor

Many women after menopause have these symptoms but don’t get help. If you notice any of these warning signs, it’s important to see your doctor:

  • Unexplained vaginal bleeding or spotting
  • Unusual discharge from your vagina
  • Burning or soreness in the vaginal area

You should also make a doctor’s appointment if sex is painful and using products like vaginal moisturizers (K-Y Liquibeads, Replens, Sliquid) or water-based lubricants (Astroglide, K-Y Jelly, Sliquid) doesn’t help.

Don’t feel embarrassed about discussing these symptoms with your healthcare provider. These are common medical issues that can be treated effectively.

Main Causes

Vaginal dryness occurs when the vaginal lining loses its natural moisture and thickness. In a healthy state, the vaginal lining consists of multiple tissue layers that maintain proper moisture. When dryness develops, these tissues become thinner and less hydrated.

The primary cause of these changes is decreasing estrogen levels in the body. Estrogen plays a key role in keeping vaginal tissues healthy, elastic, and well-lubricated. When estrogen drops, the vaginal tissues become more fragile, less elastic, and significantly drier.

Several situations can trigger estrogen decline:

  • After menopause (natural end of menstrual cycles)
  • During perimenopause (years leading up to menopause)
  • Surgical menopause (after removal of both ovaries)
  • While breastfeeding
  • During certain medical treatments including:
    • Chemotherapy
    • Radiation therapy to the pelvic area
    • Hormonal treatments for breast cancer

Some medications can also affect estrogen levels, including certain birth control pills.

These symptoms may begin during perimenopause or develop years after entering menopause. While common, not all women experience these issues during menopause. Regular sexual activity, either with a partner or solo, helps maintain healthy vaginal tissues.

Risk Factors

Several factors can increase the risk of Genitourinary Syndrome of Menopause:

  • Tobacco use can harm blood circulation and reduce blood flow to the vagina. Smoking also decreases natural estrogen effectiveness in the body.

  • Lack of vaginal deliveries may increase susceptibility. Research shows women who haven’t given birth vaginally tend to experience more GSM symptoms.

  • Limited sexual activity might contribute to GSM. Regular sexual activity (either with a partner or solo) helps maintain vaginal elasticity and increases blood flow to tissues.

Complications

Menopause-related changes to the genitourinary system can lead to several health issues:

Increased Risk of Vaginal Infections

  • Changes in vaginal acidity create a more favorable environment for infections
  • Normal protective bacteria may decrease
  • Symptoms may include unusual discharge or discomfort

Urinary System Problems

  • More frequent urination needs
  • Burning sensation during urination
  • Increased urgency to urinate
  • Higher occurrence of urinary tract infections
  • Possible urine leakage or incontinence issues

These complications often affect daily activities and comfort levels if left untreated.

Prevention

Regular sexual activity can help prevent genitourinary syndrome of menopause. This includes both partnered and solo sexual activities. When you engage in sexual activity, blood flow to the vagina increases. This helps maintain healthy vaginal tissues.

Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.