What is vaginal atrophy?

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Reduced estrogen levels can cause shrinkage of the vaginal mucosa, which results in narrowing of the vaginal opening called the vestibule. This condition is called vaginal atrophy. In this case, pain can occur during initial penetration but often subsides once the penis is deeper inside. About 90 percent of vaginal pain occurs in the vestibule region.

Vaginal atrophy can be treated with vaginal dilators—available in different widths and sizes—to help improve the elasticity and pliability of the vagina. Treatment usually involves five minutes of daily use with a lubricant. Be sure to discuss this treatment with your gynecologist before it. Your pelvic floor—just like your biceps—is made of muscle. Sex on a regular basis actually helps keep your vagina in shape. Kegel exercises help, too. Another option may be hormonal, using a low-dose application of estrogen in the vagina to restore elasticity and thickness to the vaginal tissues.

This content originally appeared on

Marcy Holmes, MSN, NP
Nursing Specialist

Vaginal atrophy is most commonly described as thinning and shrinking of the vulvovaginal tissue, often accompanied by less vaginal fluid for lubrication as well. In some cases it can also include narrowing of the actual vaginal vault [stenosis] thus making intercourse impossible. If there is significant inflammation to the vaginal tissue membrane, it is also referred to as atrophic vaginitis.

If you suspect atrophic changes there is help! First start with reading about vaginal health, and vaginal tissue changes common in menopause or even from medical treatments like chemo, radiation or estrogen aromatase inhibitor drugs. Then see a GYN practitioner for a proper evaluation and examination.

Some women find just some localized estrogen treatment helps rejuvenate the tissue to bring back comfort and pleasure in just weeks! Other more severe cases may take time using the localized treatments along with a plan of stretching the vaginal opening gently with fingers or even a set of vaginal dilators (different sizes).

If you have concerns, see a trusted health care provider who understands gynecology in menopause. Dr. Stewarts "The V-Book" is excellent.

We discuss vaginal treatments further here at

Symptoms of vaginal atrophy may start during perimenopause and worsen in menopause. The usual symptoms of vaginal atrophy include:

  • dryness
  • itching
  • pain during intercourse
  • burning with urination
  • burning with wiping
Boston Women's Health Book Collective
Administration Specialist

Vaginal atrophy (thinning of the skin of the vulva and vagina due to fluctuating or low estrogen levels) is a frequent cause of itching and irritation in women during the menopause transition and beyond.

Women who are in the menopause transition may notice vaginal dryness, irritation, or pain with intercourse as the very first sign of the transition. Since many women think that hot flashes are the first sign of menopause, we may not even think "menopause" or "perimenopause" when we begin to experience vaginal dryness. While some women with atrophy need treatment, most women with low estrogen levels have some degree of atrophy, but do not require treatment, especially if they are not having sex that includes vaginal penetration.

Our Bodies, Ourselves: Menopause

More About this Book

Our Bodies, Ourselves: Menopause

Dr. Jan L. Shifren, MD
Fertility Specialist

Lower estrogen levels, typically after menopause, cause the vaginal lining to thin and secretions to diminish. The vagina also becomes shorter and less elastic, and the vaginal opening narrows. The result is often dryness and irritation, which can make intercourse or pelvic examinations painful or impossible. This condition is known as atrophic vaginitis. Thinning of the vaginal lining combined with changes in the pH balance also can make the vagina vulnerable to infection. Urinary tract infections are more common as well, as the urethra also has estrogen receptors. If untreated, atrophy may lead to further thinning of the vaginal wall, narrowing of the vaginal opening, and even bleeding after intercourse.

Dr. Angela T. Valle, MD
OBGYN (Obstetrician & Gynecologist)

Vaginal atrophy is a common condition after menopause that causes symptoms of vaginal dryness, vaginal sensitivity and irritation of vaginal tissues. It is caused by a decrease in estrogen. There is treatment for this condition.

Vaginal dryness is a symptom of a gynecological condition called vaginal atrophy. It's characterized by burning, pain during intercourse and itching.

Continue Learning about Gynecology

The New Cervical Cancer Screening Guidelines
The New Cervical Cancer Screening Guidelines
On an episode of the controversial show Girls, Hannah finds out she’s contracted HPV. When she tells her friend Shoshanna, Shoshanna says, “Jessa has ...
Read More
Is there a natural way to treat PMS?
Dr. Mehmet Oz, MDDr. Mehmet Oz, MD
Instead of calling it premenstrual syndrome, think of it as premenstrual supplements. Why? Because y...
More Answers
12 Things Your Gyno Wants You to Stop Doing
12 Things Your Gyno Wants You to Stop Doing12 Things Your Gyno Wants You to Stop Doing12 Things Your Gyno Wants You to Stop Doing12 Things Your Gyno Wants You to Stop Doing
Skipping annual appointments, self-treating symptoms and other gyno no-nos.
Start Slideshow
Do I Need an Annual Check-Up?
Do I Need an Annual Check-Up?

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.