Atrophic Vaginitis and Menopause: What you need to know about your vaginal wall during menopause

During our last blog, we discussed the changes your body goes through during menopause, due to the shift in estrogen and other hormones. Today we will continue discussing the physical changes you might want to look out for during menopause. 

Postmenopausal atrophic vaginitis, also known as vaginal atrophy, is essentially the thinning of the vaginal walls caused by decreased estrogen levels during/after menopause. When your vaginal wall is thin, you may experience negative effects like infections or painful sex. According to the American Association of Family Physicians, up to 40 percent of postmenopausal women have symptoms of atrophic vaginitis - so it may be wise to consider the possibility. 


While not everyone who goes through menopause experiences symptoms or even has this side effect at all, atrophic vaginitis is not uncommon. This is caused ultimately by the decrease of estrogen in a woman’s body during menopause. There are actually some other factors that may make some women more at-risk for this side effect than others. 

Risk Factors:

  • Smoking - Smoking cigarettes can impact more than just your lungs! Cigarette smoking affects your blood circulation. And may lessen the flow of blood and oxygen to the vagina and other nearby areas. Smoking also reduces the effects of naturally occurring estrogens in your body. 
  • No vaginal births - Interestingly, researchers have observed that women who have never given birth vaginally are more likely to develop vaginal atrophy than those who have. 
  • No sexual activity - Whether you’re engaging in sexual activity with a partner or flying solo, sex and arousal increase blood flow and can make your vaginal tissue more elastic. When you aren’t sexually active, your muscles aren’t being worked out and this can increase your risk of developing atrophic vaginitis. 

While of course, these factors will not guarantee vaginal atrophy will occur in any given woman, these are a few of the traits doctors have noticed having a connection to this development. 


While the most obvious symptom that comes to mind is the namesake symptom, the thinning of the vaginal walls, there are many other features that often appear along with atrophic vaginitis. 

These include:

  • The shortening and tightening of the vaginal canal
  • Lack of vaginal moisture; vaginal dryness 
  • Vaginal burning; inflammation
  • Discomfort or pain with urination
  • Frequent and urgent urination
  • Genital itchiness
  • Discomfort during intercourse, spotting after intercourse
  • Frequent urinary tract infections (UTI’s)
  • Urinary incontinence (involuntary leaking)

If you experience any combination of these symptoms while going through menopause, it might be time to bring it up to your doctor for a professional opinion. 


While it can sometimes be uncomfortable to bring up to a doctor, this is an important thing to talk about, especially if you are experiencing pain or discomfort. This is of course how you will get treatment and relief for your symptoms!


Your doctor will have their ways of checking you out for atrophic vaginitis, but they may start with these techniques:

  • Pelvic examination
  • Vaginal smear test
  • Vaginal acidity test
  • Blood test
  • Urine test

It might sound intense, but if you’ve made it to menopause, you’ve probably experienced most of these at some time in your life! 

Some of these tests, like the blood and urine test, will test what’s going on within you - specifically, your estrogen levels, which will be a telltale sign. But others, like the pelvic exam, are focused more on physical, visible symptoms; that is because vaginal atrophy impacts you externally as well!

Here are some things your doctor might look for when examining your vulva:

  • The pale, smooth, shiny vaginal lining
  • Loss of elasticity
  • Sparse pubic hair
  • Smooth, thin external genitalia
  • Stretching of uterine support tissue
  • Pelvic organ prolapse (bulges in the walls of the vagina)

Once your doctor is satisfied with the results of their test, you will have your answer one way or another. But, if you do indeed have atrophic vaginitis, there is no need to panic! There are some available treatments to you which can relieve much of your discomfort. 


Topical Estrogen 

  • Topical estrogen (estrogen applied through skin contact) limits how much estrogen can get into the bloodstream, meaning that it does not have a connection to an increase in the risk of cancer. 
  • Topical estrogen doesn’t treat any systemic symptoms of menopause, like the dreaded hot flashes. This is meant to treat the underlying issue of reduced estrogen, not the general symptoms of menopause. 
  • This is available in many forms, like the vaginal estrogen ring, vaginal estrogen cream, and vaginal estrogen tablets. 
  • A risk of utilizing topical estrogen is that, if the ointment is not fully absorbed into the skin, estrogen can be transferred from your hands or body to other surfaces. 

Oral Estrogen

  • Oral estrogen can be used to treat hot flashes and vaginal dryness, unlike its topical cousin. 
  • Also unlike topical solutions, however, is that oral estrogen can be linked to an increase in risk of cancer. Because of this, women with a history or high risk of cancer should not take oral estrogen. 

Of course, you can also address issues of discomfort, itchiness, and dryness with topical moisturizers. By ensuring that your moisturizer is specifically formulated for use in your most personal area, you can prevent further discomfort and in fact relieve some issues atrophic vaginitis can introduce. 

Using a hormone-free, intimate revitalizing cream like REJUVENATE is particularly beneficial if you suffer from dryness, itchiness, or soreness because of menopause and atrophic vaginitis. Rejuvenate provides moisturizing and protective properties, without any of the risks posed by estrogen creams designed for the area. 

Many women have found that incorporating Rejuvenate into their daily routine has helped them have less of a reliance on medications, and found relief with hormone-free options.

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