What Does Vaginal Atrophy Feel Like? How to Know if You Have It

Menopause makes you feel alone and isolated. The intimacy you once had seems to have shriveled up with your youth. You want to want sex, but the thought of putting anything in your delicate, dry vagina makes you cringe. How do you explain that sex makes you cry? You wonder how many more sexless nights your partner will tolerate.

Before you throw in the towel on your love life, consider treating the cause of menopausal symptoms. Learn what vaginal atrophy feels like, and how to treat it so you can bring intimacy back.

What Is Vaginal Atrophy?

Vulvovaginal atrophy (VVA) is a condition caused by decreased estrogen in the vaginal tissue. It can happen at any time in a woman’s life, but it’s most common in menopause. ^[1]

Also called genitourinary syndrome of menopause (GSM), vaginal atrophy is pretty common. About 50% of women report having symptoms during menopause. ^[2] 

Before menopause, estrogen keeps the vaginal tissue moist, elastic, and thick. Vaginal folds allow it to stretch during sex and childbirth. 

Low estrogen in menopause causes the tissue to thin out and lose its stretch. The vaginal folds begin to disappear. ^[3] A dry and thin vaginal lining creates a painful environment at rest and during sex. The vagina becomes shorter and narrower – especially if there’s little sexual activity going on.

Causes

In menopause, the ovaries stop producing the sex hormones estrogen and progesterone. Estrogen maintains vaginal integrity, supplying blood to the area to keep it thick and stretchy. It also helps to maintain an acidic environment; a low pH protects your vagina from germs that can cause infections. 

Vaginal atrophy is a result of low estrogen levels. The vaginal tissue begins to “atrophy,” or waste away. The tissue loses its integrity and elasticity, which makes it more prone to tears and bleeding. The vaginal pH also increases, which increases the risk of infections.

Symptoms 

Physical changes to the vagina and vulva cause discomfort and pain. Symptoms of vaginal atrophy include: ^[1]

• Irritation
• Dryness
• Soreness
• Incontinence
• Pain or bleeding with sex
• Frequent or urgent peeing
• Pain with peeing

Vaginal atrophy can also cause recurrent urinary tract infections, which need to be treated with antibiotics. Talk to your doctor about your symptoms to make sure you get the right treatment.

How to Tell if it’s Vaginal Atrophy or Something Else

Your doctor may check for vaginal atrophy with lab tests or by doing a physical exam. In a pelvic exam, your doctor looks for changes like dry or pale tissue and a shorter vagina with fewer ridges.

Tests to diagnose vaginal atrophy include: ^[4]

• Vaginal pH
• Vaginal smear
• Urine sample
• Ultrasound
• Blood hormone levels

Vaginal atrophy shares symptoms with other conditions, so be sure to discuss all of your symptoms with your provider. 

For instance, atrophy can cause light vaginal bleeding after sex. If you have significant bleeding (similar to a period), this could be a sign of a serious problem. Let your doctor know if you have vaginal bleeding after menopause. 

Yeast infections also have similar symptoms such as redness, itchiness, and pain in the vaginal tissue. However, they often cause a thick vaginal discharge that is not typical of vaginal atrophy. Review your symptoms with a healthcare provider to be sure you’re treating the right issue.

Can Vaginal Atrophy Be Reversed? Learn How Menopause Treatments Will Help 

One of the most common menopause treatments is hormone therapy (HT). It replaces depleted hormones to get to the root of menopause symptoms like vaginal dryness. 

Getting to the root of a problem helps reverse symptoms, but HT isn’t right for everyone. Here are your options for both hormonal and nonhormonal treatment for vaginal atrophy. 

Hormone Therapy 

Hormone therapy is used to treat severe vaginal atrophy symptoms. Medications like ospemifene help with painful sex. A low-dose estrogen cream, tablet, or ring treats dryness and pain. ^[5]

Talk to your doctor about your risk factors before starting hormone therapy. Certain criteria may increase your risk of hormone-dependent cancers. Read more about hormone therapy for menopause symptoms on the Foreverbetty Blogs.

Nonhormonal Treatment 

Whether you prefer medical treatment or a natural approach to managing menopause, you can take steps to maintain a healthy vagina. Here are some ways to treat vaginal atrophy without hormone therapy. ^[6] 

1. Have Regular Sex

It may sound counterintuitive, but regular sex maintains a healthy vagina. It promotes blood flow to the vagina, maintaining its integrity and tissue elasticity. You don’t need a regular sexual partner, either – vibrators and sex toys are just as effective at stimulating the lady parts.

2. Try Vaginal Moisturizers

Lubricants reduce friction, making sex less painful and more pleasurable. Vaginal moisturizers provide long-term relief from vaginal dryness. 

Haven’t found the winning moisturizer yet? Check out the Foreverbetty subscription box, which features a variety of menopause products. Every month, your trusted friends (who’ve been there/done that!) at Foreverbetty send meno-relief products right to your door. 

3. Get Moving 

So we’ve learned sex is one of the best workouts for the vagina, but what are some other physical exercises for stimulation? Experts recommend: 

• Yoga
• Pelvic floor physical therapy
• Kegels

These exercises help with arousal, pain during sex, and strengthening of the vaginal tissue.

4. Sex Therapy 

Menopause is a confusing time, and it can be hard to find a friend who fully relates to your experience. If you’re struggling in the intimacy department, it may be time to chat with a trained professional. 

A sex therapist helps you work through challenges related to your changing body. You can go to sex therapy with or without your partner. 

Start Treating Vaginal Atrophy Today

Menopause changes everything – but your sex life doesn’t have to end just because your period stops. If intimacy has taken a backseat in your life, it may be time to get relief from vaginal atrophy.

Subscribe to Foreverbetty, a subscription box packed with goodies that alleviate menopausal symptoms. Each month, get pampered with products like creams and lubricants for vaginal dryness. Join the mailing list to stay up-to-date on the latest products that make menopause a little easier.