Vaginal Dryness

Published: August 9, 2016

We are thrilled to announce the launch of our new, educational resource on vulvovaginal atrophy-!

Filled with invaluable information on the health topic, along with symptoms, risks, treatment options and resources.

The Changing V Zone at Menopause

Vaginal dryness is a common problem at menopause, but it also can occur at any age.
During and after the menopause transition, when symptoms of vaginal dryness are caused by declining estrogen levels, this problem is called atrophic vaginitis.

An estimated 10%-40% of postmenopausal women have symptoms related to vaginal atrophy.  Estrogen helps keep vaginal tissues healthy by maintaining vaginal lubrication, tissue, elasticity and acidity. As a result, reduction of estrogen, the vaginal tissue shrinks, becomes thinner, less elastic, fragile, causing dryness and makes us have an increased risk for developing urinary tract infections. It’s important for you to learn how to recognize and treat the symptoms of vaginal dryness.

There are other potential causes for vaginal dryness which include the following:

  • Childbirth, breastfeeding
  • Radiation or chemotherapy
  • Surgical removal of ovaries
  • Anti-estrogen medications
  • Sjögren’s syndrome
  • Douching
  • Allergy and cold medications
  • Certain antidepressants


  • Vaginal soreness, itching or burning
  • Vaginal discharge
  • Painful sexual intercourse
  • Light bleeding after intercourse
  • Burning on urination

Atrophic vaginitis is vaginal dryness due to thinning tissue and decreased lubrication, caused by a decrease in estrogen.  By some estimates, nearly half of postmenopausal women experience vaginal atrophy.  However, few seek treatment.  May occur in sexually active women OR those who are not sexually active. Changes can increase likelihood of trauma from sexual intercourse, douching and more. Vaginal atrophy symptoms include the following:

  • Redness
  • Itching
  • Dryness
  • Possible narrowing/shrinkage of vaginal opening and vagina
  • Loses plumpness/firmness
  • Lining thins
  • Furrows and folds disappear
  • Color becomes red instead of pink
  • Less mucous
  • Becomes less acidic
  • Easier for bacteria to grow
  • Pain with intercourse

Many women believe that menopause symptoms end and when the hot flashes stop. They don’t realize that vaginal atrophy is a common consequence of low estrogen levels and do not think there is help for sexual and vaginal health related issues.  Often, women are unaware of treatment options and find short-term solutions for relief instead of treating the underlying problem.

A visit to the clinician may be in order if your symptoms impact your lifestyle including your relationship with your partner, sex, health and overall feeling of well-being.

Exams and Tests

Diagnosing vaginal atrophy may include a pelvic exam, urine test and acid balance test.

Treatment options include:

  • Lifestyle changes (avoid scented soaps, lotions, perfumes or douches)
  • Non-hormonal (moisturizers/lubricants and SERM)
  • Estrogen therapy (cream, ring or tablet).  Prescription estrogen works well.  It is placed directly into the vagina and estrogen is delivered directly to vaginal area.  Only a little is absorbed into the bloodstream
  • A combination of different therapies
  • Vaginal atrophy related symptoms may be prevented with regular sexual activity (with or without partner).  Sex enhances blood circulation to vagina, helps keep vaginal tissues healthy and keeps sex organs healthier for longer.
  • Helpful tips to minimize symptoms include:
  • Avoid tight-fitting undergarments (pantyhose, jeans)
  • Limit time in wet bathing suit
  • Wash clothing with non-perfumed/low-allergenic washing products
  • Avoid fabric softeners
  • Avoid feminine hygiene sprays or douching
  • Avoid pads, tampons, toilet paper that are scented
  • Quit smoking

The most important part of the equation is opening up the lines of communication between you and your clinician, and your partner. With your partner, be sure to be honest first and foremost.  Menopause symptoms may unintentionally confuse or hurt your partner.  Most people are not mind readers – they may not recognize the profound inner emotional and physical changes at menopause.

Call your clinician if your symptoms of vaginal dryness do not go away.

Finding the proper treatment will ease vaginal dryness symptoms.