Not to scare you or anything, but as we age, our body naturally slows down and become weaker. And while having a good diet and doing regular exercises can help to slow down the effects of aging, our bodies will inevitably go through changes.

As women, we dread menopause and all its baggage. After all, who wants to be infertile, riddled with mood swings and worst of all, hot flashes, where you constantly wonder who keeps messing with the thermostat.

Another challenge you might have to face during menopause is postmenopausal atrophic vaginitis or simply put vaginal atrophy.

What is an atrophic vagina?


To understand what an atrophic vagina is, you must first understand what it means for something to be atrophic.

Something that is atrophic has wasted away or decreased in size and strength. From a medical standpoint, this term refers to an organ or tissue that has been deprived of nutrients, hormones or blood, or has been overused, and whose function has since declined.

We all know what a vagina is right? But for information purposes, a good definition for the vagina is a stretchy, muscular canal or tube which acts as a passageway from the uterus to the outside world during childbirth. This organ is exclusive to the female sex and has a flexible, mucous lining with sensitive nerve endings responsible for lubrication and pleasure when she is aroused.

When you put the two terms together, you will find that an atrophic vagina is one which has decreased in size and strength, and whose functions have since declined.

Here, the walls or lining of the vagina has become thinner, resulting in dryness and irritation. This can have an effect on a woman’s sex life and can make her transition to old age uncomfortable and disheartening.

Here is why it happens.

How Atrophic Vaginitis Develops


Atrophic vaginitis typically occurs in women who are postmenopausal. After menopause, your body undergoes hormone imbalance, particularly in sex hormones. Sex hormones such as estrogen play an important role in maintaining the reproductive cycles and functioning of the sex organs.

After menopause, your body does not need to regulate reproduction, so there is a drastic decline in the production of sex hormones. Without estrogen, the tissues which make up the vagina begin to thin and dry out. As the vagina shrinks, it becomes less elastic and more susceptible to injury, and this is known as atrophic vaginitis.


Other Factors for Atrophic Vaginitis

Besides menopause, there are other reason for your atrophic vagina.

Surgical menopause- removal of the ovaries before the age of natural menopause, or during a hysterectomy (removal of the uterus)
Premature menopause– Otherwise known as early menopause, before the age of 45. This is experienced by roughly 5% of women as a result of smoking, genetics, and certain autoimmune conditions.
Breastfeeding and vaginal birth- During pregnancy, hormones such as prolactin increase in order for the mother to lactate. After childbirth when breastfeeding begins, a woman will experience low levels of estrogen, which continues for some time as she nurses her child.
Chemotherapy and Pelvic Radiation for treating cancer– Certain chemo drugs can cause a decline in estrogen levels as they disrupt ovarian function.
Lack of sex- Regular sex helps to keep the vagina tissues healthy. A lack of sex can, therefore, contribute to dryness and tightness. The tissues can become thin and may tear, get injured or bleed when she finally decides to have sex.

Using harsh soaps, smoking, latex condoms and douching may also contribute to this condition.

Symptoms of Atrophic Vagina


Vaginal atrophy is so common, that to 40% of menopausal women will experience its symptoms. Unfortunately, only around 20-25% of women will seek medical help.

If you someone you know are experiencing the following symptoms, you may want to consult your doctor because it very well is vaginal atrophy:

Bacterial vaginosis or Yeast infection
Abnormal vaginal discharge (thin, watery, yellow or grey)
Paleness and thinning of labia and vagina
Frequent Urinary Tract Infections (UTI)
Urinary incontinence
Burning and light bleeding when peeing
Tightening and shortening of the vaginal canal.
Discomfort, pain and light bleeding during intercourse
Reduction or sparseness in pubic hair

Risks associated with Atrophic Vaginitis


Atrophic vaginitis increases your risk of getting a vaginal infection because it alters the acidic environment of the vagina. These changes can promote the growth of bacteria and fungi.

Diagnosis of Atrophic Vagina


If you have any of the aforementioned symptoms, the only way to know if you are experiencing vaginal atrophy for sure is to visit a gynecologist.

Before a diagnosis of vaginal atrophy can be reached, your doctor will question you about your medical history. These questions will include your menstrual patterns, when your menstrual cycles begun and ended, the symptoms you have experienced during menopause, your surgical history, any medications you are taking and even about your sexual history and your vaginal hygiene.

If he/she suspects that the culprit may be atrophic vaginitis, he/she will perform a pelvic exam to look for physical signs of vaginal atrophy. These include:

Appearance of a pale, shiny and smooth vaginal lining
Sparse presence of pubic hair
Loss of vaginal elasticity
Thin and smooth external genitals
Bulges in the vaginal walls
Stretched uterine support tissues

You may also be required to do additional tests such as :

vaginal acidity test- where vaginal secretions are examined
vaginal smear test- where tissue scraped from the vaginal walls are examined.
blood test
urine test.

This will determine the pH of your vagina, estrogen levels, WBC (white blood cell) count and bacterial count.

Your doctor may also do an endometrial biopsy, where a piece of tissue is removed from the uterine lining and examined to rule out endometrial cancer.

Treatment of Atrophic Vagina


The symptoms of vaginal atrophy will continue until it is treated or until estrogen levels rise. Luckily, there are numerous products that help to treat vaginal atrophy

The most popular treatment method is prescribing estrogen. Estrogen is available in numerous forms, such as creams, gels, patches, and implants.

Topical estrogen can come in different forms. This type of estrogen enters the body through the skin which then enters the bloodstream. Topical estrogen can be in the form of:
A ring- Vaginal estrogen rings are soft, flexible rings that are inserted in the upper part of the vagina. This ring releases constant doses of estrogen for as long as three months
A cream- Estrogen creams are inserted into the vagina daily, typically at bedtime.
A tablet- These tablets are inserted into the vagina at least once per week using a disposable applicator.
Oral estrogen is much stronger than topical estrogen and is used primarily for menopausal women. These are taken by mouth.

You may also use over-the-counter moisturizers and water-based lubricants to combat dryness during sexual intercourse.



The best thing you can do is schedule regular visits with your gynecologist or communicate with him/her as soon as you feel like something is wrong or slightly off. This way, atrophy can be detected in its earlier stages and treatment will be more effective.

Vaginal atrophy can be prevented by making certain lifestyle changes.

For one, regular sexual activity can help to improve blood circulation in the vagina and increase moisture. While this will not boost estrogen production, it will help to ease discomfort and keep the vagina healthier for longer. Using lubrication can also help, as will increasing the amount of time spent on foreplay.

Wearing cotton underwear and loose-fitting clothing can also help with its symptoms, and slow its progression. Air circulation helps to prevent bacterial growth and prevent discomfort.

Consuming foods rich in estrogen can also help to boost your estrogen levels naturally, as prolonged use of estrogen supplements will put you at risk of developing certain cancers. Foods rich in estrogen include flax seeds, fresh apricots, red grapes, oranges, peaches blueberries, red wine, walnuts, pistachios, peanuts, and soy.

Herbal teas such as black and green teas, Dong Quai and red clover may be helpful. Reducing smoking, alcohol and sugar intake may also have a positive effect on your vaginal atrophy.

Bottom Line


Atrophy vagina usually occurs after the menopause, and it can happen to you. While it can be onset by other factors, educating yourself on this condition is the first step you can take to prepare yourself for it.

Vaginal atrophy is a treatable condition and there are many ways you can minimize and even prevent the symptoms. If you wish to go the natural route, paying close attention to what you eat and using vaginal moisturizers can help a lot. If it gets very bad or unbearable, be sure to consult your doctor. He/she will know exactly what to do.

Having an atrophic vagina is not the end of the world. Once you listen to your vagina, treat her well and get the care she needs, everything will be just fine.




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