How menopause causes vaginal changes

One of the main areas impacted by menopause is the vulva and vagina. Since the vagina makes up a big part of female anatomy and the reproductive system, it’s no surprise that vaginas change as female hormones change. 

Menopause can impact your sex life, but there are lots of ways to prepare for these years. As estrogen decreases, the vaginal lining becomes thinner, which results in dryness and irritability. This combination of symptoms can lead to discomfort in general and especially during sex.

If you want to learn more about how the vulva and vagina change during menopause and the best way to manage your symptoms, read ahead. 

Changes during intercourse

More than half of women who experience postmenopause are affected by vaginal atrophy, which occurs when the vagina opening and vulva become dry due to a drop in estrogen levels. This dryness can make sex uncomfortable and even painful. Since vaginal dryness depletes the vagina of its natural lubricant and thick layers, the vagina will have a difficult time expanding for a penis. Some may feel irritated and inflamed, and notice redness near the vagina. 

Vaginal burning can occur even if you’re not having sex. These hormonal changes can affect you when you pee, too.

Changes in urination

You may feel a burning sensation when you pee because the tissues that line the urethra (the tube that connects your bladder to the outside) also become thin. When estrogen decreases, the tissue lining your bladder loses strength and its natural ability to fight bacteria. As a result, recurrent urinary tract infections are very common during and after menopause. 

Changes in appearance

Menopause can cause the vagina to feel and look different because of hormonal changes and a general loss of skin elasticity. The vagina walls become thin, which isn’t something you can see since it’s internal. But you can see your labia minora, which is part of the vulva, become thinner and flatter. It’s perfectly normal for your vagina to change in size and shape, especially after puberty, childbirth, and menopause. Lubrication is highly recommended!

Treatment for vaginal changes

Here are a few ways to ensure your vagina is feeling its best, even with a decrease in estrogen. 

  • Lubricant can work wonders for vaginal dryness during intercourse
  • Massaging the vulva with Vaseline or coconut oil for routine dryness prevention
  • Hormone replacement therapy can replace estrogen and help decrease dryness, UTIs, and other hormone-related side effects
  • Wear comfortable cotton underwear to avoid chafing and irritation 

Reviewed by the Ovia Health Clinical Team


Gandi, Jason. “Genitourinary syndrome of menopause.” American Journal of Obstetrics and Gynecology. 215(6):704-711. Web. December 2016. 

“New Solutions for Menopause-Related Chronic Urinary Tract Infections.” Women’s Healthcare of Princeton. Women’s Healthcare of Princeton.

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