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BCM - Baylor College of Medicine

Giving life to possible

Obstetrics and Gynecology

Vaginal Atrophy

Vaginal atrophy is when the vaginal walls become thin, dry and inflamed due to a decline in estrogen in a woman's body, typically brought on by menopause.

Vaginal atrophy can make sexual intercourse painful. It can also make the vagina more susceptible to painful infections and urinary problems.

Simple, effective treatments are available. Regular sexual activity also helps you maintain healthy vaginal tissues.

While the condition is common, not all menopausal women will develop vaginal atrophy.

What causes vaginal atrophy?

Vaginal atrophy is caused by a loss of estrogen. Less estrogen in the body makes the vaginal walls thinner, drier, less elastic and more fragile. Vaginal atrophy may occur:

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

What are the risk factors for vaginal atrophy?

Additional risk factors that may contribute to vaginal atrophy include:

  • Smoking
  • Never giving birth vaginally

What are the symptoms of vaginal atrophy?

Some women with mild vaginal atrophy will experience no symptoms. Women with moderate to severe vaginal atrophy may experience symptoms that include:

  • Vaginal dryness
  • Vaginal burning
  • Watery discharge
  • Burning with urination
  • Urinary incontinence
  • Urgency with urination
  • More urinary tract infections
  • Light bleeding after intercourse
  • Painful or uncomfortable intercourse
  • Shortening and tightening of the vaginal canal

How is vaginal atrophy diagnosed?

Diagnosing vaginal atrophy starts with a detailed medical history and comprehensive physical exam, including:

  • A pelvic exam
  • A Pap smear
  • A urine test

How is vaginal atrophy treated?

For women who are not having symptoms, treatment may not be necessary. For women who are experiencing symptoms and seek relief, treatment options include:

Non-hormonal treatments. Over-the-counter vaginal moisturizers or lubricants can relieve mild symptoms.

Topical estrogen therapy for vaginal dryness. Comes in several forms, including creams, vaginal rings, suppositories and tablets.

Hormone treatment. To restore thickness and elasticity of vaginal tissues. Talk with your doctor about the risks and benefits.

In addition, women should avoid intercourse if they have any vaginal irritation.

How can I prevent vaginal atrophy?

While prevention may not be possible, steps can be taken to keep your vaginal tissues healthy include:

  • Regular sexual activity, which enhances blood flow to your vagina
  • Avoid smoking, which impairs blood circulation and reduces the effects of your body's natural estrogen