Vaginal Atrophy: Symptoms, Causes, and Treatments

Last updated 05.09.2024 | by Sabrina Johnson | 7 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.


Many women experience vaginal atrophy during their perimenopause and menopause stages; however, very few openly talk about it or get diagnosed.

The word ‘Vaginal Atrophy’ (1) is considered somewhat insulting, which is why women get embarrassed or uncomfortable to freely discuss it. Besides, it is also clinically misleading because the condition causes not only sexual pain but also many urinary problems, including incontinence, urinary tract infections, etc.

Millions of women suffering menopausal symptoms go undiagnosed, and one of the reasons behind it is bad terminology.

So, in 2014, a new term was introduced to include the urinary system in this condition: Genitourinary Syndrome of Menopause (GSM). However, this term is still not commonly used everywhere.

Keeping the name part aside, the condition should not be neglected, as it can cause severe medical problems. As women, we know our real struggles and the significance of diagnosis. This is the reason today I will be discussing atrophic vaginitis (Vaginal Atrophy), its symptoms, causes, diagnosis and treatments.

If you’re dealing with this situation and don’t know what to do, read this article thoroughly to learn all about the condition.

(I will be using the term vaginal atrophy frequently in this article because it is more commonly used, and most women are only aware of this name).

What are the Symptoms of Vaginal Atrophy?

Before diving into the symptoms, first, let me give you an idea about what exactly vaginal atrophy is. Vaginal atrophy is a condition of thinning, drying, and inflammation of vaginal walls due to decline in estrogen during and after menopause.

Vaginal Atrophy or Genitourinary Syndrome of Menopause is a common ailment among women, and the symptoms (2) start either during perimenopause or menopause.

The symptoms are:

  • Vaginal Dryness 
  • Vaginal Burning
  • Genital Itching 
  • Pain during Sexual Intercourse
  • Unusual Vaginal Discharge
  • Spotting or Bleeding after Intercourse
  • Decreased Vaginal Lubrication during Sex
  • Frequent Urinary Tract Infections (UTIs)
  • Incontinence (unable to hold your pee)
  • Frequent Urination 
  • Painful/Burning Urination 
  • Blood in Urine

A study (3) was conducted on a total of 70 postmenopausal women (aged between 40 to 75 years). According to the results, vaginal atrophy (VA) was not considered a medical condition by most menopausal women, and they had not sought any specific treatments for VA.

Despite the distress caused, those women didn’t seek treatment because of embarrassment and lack of awareness. Many were also dismissed by medical professionals, stating that it’s a normal part of aging.

What Causes Vaginal Atrophy During Menopause?

Vaginal Atrophy is caused due to decline in estrogen during menopause. In the menopausal stage, your body produces less estrogen, due to which the vaginal lining becomes thinner and less stretchy.

A decline in estrogen also leads to less production of vaginal fluids, which causes dryness and makes your vaginal tissue delicate and prone to irritation and burning.

Decrease in estrogen can also occur due to:

  • Perimenopause 
  • Surgical menopause (after removal of ovaries)
  • Chemotherapy
  • Breastfeeding 
  • Pelvic radiation therapy for cancer 
  • Hormone Therapy
  • Anti Estrogen medications

Women experience the signs and symptoms of Genitourinary Syndrome of Menopause in the early stages of menopause or postmenopause. However, it is not necessary that every woman will suffer from vaginal atrophy. To keep your vaginal tissues healthy, participate in regular sexual activities. A healthy sex life benefits you in many ways.

Diagnosis

If you experience any of the symptoms mentioned above, seek medical attention and consult your doctor about your problems. As it is an intimate problem, most women are uncomfortable talking to their doctors. However, it is necessary to take medical advice to avoid potential complications.

Doctors will diagnose vaginal atrophy based on your symptoms and pelvic exam. They will also examine external genitalia for any physical signs such as loss of elasticity, pale vaginal lining, or stretching of uterine support tissue. They will also conduct tests such as ultrasound, urine test, acid test, pap test, etc.

The healthcare providers might also ask questions about your health history. Some of the common questions include:

  • Duration since you had your last periods?
  • Do you ever have cancer?
  • Medications you take?
  • Do you experience pain during intercourse?
  • Bleeding or spotting?
  • When did you start having these symptoms?

Treatments for Vaginal Atrophy

Proper treatment can improve your vaginal health and control the symptoms. There are several methods to treat vaginal atrophy. Women suffering from GSM should definitely consult their doctors and get adequate treatment to eliminate the condition and enhance their quality of life.

Let’s know about the various treatments:

Topical Estrogen

Topical estrogen helps to treat vaginal atrophy symptoms. It is available in several forms.

  • Vaginal Estrogen Cream: There are creams available which you must put into your vagina with an applicator. Most doctors prescribe the cream daily in the initial period, but later, they reduce the usage to two to three times a week.
  • Vaginal Ring: Vaginal ring is a soft, flexible, thin ring that is inserted into your vagina by your doctor. It releases a constant dose of estrogen and is replaceable every three months.
  • Vaginal Tablet: A tablet is inserted into your vagina using an applicator. Initially, it is prescribed daily, but later, only 2 to 3 times a week.

Consult your doctor before going forward with any of these options. They will discuss each option, the risks involved, and which may work best for you.

Oral Estrogen

Mainly oral estrogen is used to treat hot flashes and vaginal dryness during menopause. Doctors prescribe them in pills or patch form; however, they aren’t recommended to people who have had cancer.

Consuming these may cause bleeding after menopause. It is mandatory to consult your doctor and discuss everything before moving forward with this option.

Non-Hormonal Treatments

Medical professionals will help you to decide which treatment option works for you after conducting a thorough examination. The severity of symptoms plays a major factor in choosing your treatment plan.

Hormonal therapies are not suitable for everyone, so there are also some non-hormonal treatments that can help to deal with vaginal atrophy.

  • Lubricants and Moisturizers

Women dealing with GSM should use lubricants and moisturizers to control vaginal pain and dryness. Lubricants provide comfort during sex by reducing pain and friction.

Moisturizers help the cells to maintain moisture. You can also use some natural oils for relief.

  • Laser Treatments

Some laser treatments help to improve the strength and elasticity of vaginal tissue. However, for this, you need to have a proper medical consultation.

  • Dilators

This is a device that widens your vagina. It provides comfort during sex and reduces pain.

FAQs

What are the symptoms of vaginal atrophy?

Symptoms of vaginal atrophy include vaginal dryness, itching, burning, pain during sex, frequent urination, UTIs, etc.

Can vaginal atrophy be treated?

Yes, there are several treatment options available, such as topical estrogen, lubricants, estrogen creams, laser therapy, etc. However, always consult your doctor first.

Why do I feel embarrassed to talk about vaginal atrophy?

Most women feel it is embarrassing to talk about vaginal atrophy. However, it is a common condition that affects many menopausal women. You should not be ashamed to seek treatment for a normal change your body goes through. Don’t hesitate to talk to your doctor.

Conclusion

Vaginal atrophy is a condition suffered by a lot of women during their menopausal stage. The symptoms start to show in perimenopause or postmenopause. Never ignore any symptoms and immediately seek medical advice.

Getting treatment will help you pass through the stage comfortably. Don’t hesitate—consult your doctor and get treated.

Author

  • Sabrina Johnson

    Meet Sabrina Johnson, a compassionate author and a seasoned expert in Obstetrics and Gynecology. She is a driving force behind Simply Menopause, where her extensive medical knowledge and empathetic nature come together to empower women in their menopausal journey. Sabrina offers culturally sensitive guidance and support through her approachable writing, making her a trusted friend on the path to menopause wellness.