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What is Vaginal Atrophy and why does it happen?

What is Vaginal Atrophy and why does it happen?

Vaginal atrophy is when the walls of the vagina get thin, dry and inflamed and can happen when the body makes less oestrogen, such as during and after menopause.

This condition can cause symptoms both in the vagina and the urinary tract, and together are called genitourinary syndrome of menopause (GSM)

5 Symptoms of Atrophy

1      Burning or itching in your Vagina

When vaginal tissues become inflamed as the result of vaginal atrophy, you may feel a burning or itching sensation in your vagina.  This may occur randomly or at certain times, such as after sex or when you urinate. 

2      Frequent Urinary Tract Infections (UTI’s)

As your vaginal tissues become thinner, you may be more prone to infections that occur when bacteria spread from your vaginal area to your urethra (which carries urine outside your body from your bladder), bladder, ureters (which carry urine from your kidneys to your bladder), and even your kidneys. 

3      Spotting or mid cycle vaginal bleeding

As the tissue that lines your vagina becomes thinner, blood vessels within it have less protection and may leak blood, especially when subjected to friction or pressure from sexual intercourse.

4      Dryness and pain during sex

A reduction in oestrogen can lead to a decrease in the production of vaginal fluids that serve as lubricants in your vagina. When your vagina is dry, sexual penetration can be more difficult and sexual intercourse may become painful. This can lead to a loss of sexual enjoyment, as well as problems between you and your partner. 

5      Trouble reaching orgasm.

If sex is uncomfortable or painful, it’s not surprising that you may have gone off it or have trouble reaching orgasm – a condition known as orgasmic dysfunction. Vaginal atrophy is a common cause of orgasmic dysfunction during midlife.


Available Treatment

The following information is for guidance only and not to be used as a replacement for medical consultation

Have more Sex!  Sound ridiculous doesn’t it when it’s often the last thing you want if it causes pain, but those who have regular sexual activity, (by themselves or with a partner) tend to have milder cases of vaginal atrophy than those who don’t.  Sexual activity raises blood flow to the vagina and helps it stay elastic and naturally lubricated.

Some of the following may help:

  • Lubicants and Vaginal moisturisers – Sylk, YesVM, Replenish
  • Localised oestrogen such as Vagifem, Vagirux, Imvaggis, Estriol cream and Ovestin.
  • Intarosa is also designed for severe atrophy and painful sexual intercourse.
  • Estring which is a tiny ring that releases estradiol into the vagina in a consistent, stable manner for 90 days.


Helpful resources to find out more



  • The Dr Louise Newson Podcast
  • On My Last Eggs
  • The Happy Menopause
  • Menopause Madness