As women age, there are going to be inevitable changes that occur in the body. Some of the changes may directly affect the reproductive tract. And in women, this could mean physical changes in the reproductive tract that are affecting one’s sexual life. This can cause major relationship problems that end up affecting the quality of life for both partners.

Different branches of medicine such as alternative medicine and regenerative medicine have created methods that can slow down aging, reverse aging, and give people an improved quality of life. They do this by affecting cells, tissues, and reproductive system organ function with various treatments. Because of this, questions such as what vaginal atrophy is and can vaginal atrophy be reversed can be answered although answers may not come from traditional medical doctors.

What is vaginal atrophy?

Vaginal atrophy refers to the thinning of the vaginal walls that is usually accompanied by vaginal dryness[1] and inflammation as well as urinary symptoms. This condition makes it painful to have intercourse and causes urinary tract symptoms. It’s a known condition that all doctors understand, can recognize, and managed by those in the OB/GYN and Geriatrics specialties. So you’ll never find that a doctor looks perplexed if you ask what is vaginal atrophy.

Some of the urinary and other symptoms that occur with vaginal atrophy[2] may include the following:

  • genital itching
  • frequent urination
  • urinary incontinence
  • burning and frequency of urination
  • recurrent urinary tract infections – Urinary tract infections are more common with vaginal atrophy because bacteria may spread to the remaining “thin” tissues more quickly.
  • light bleeding after intercourse

If you ask doctors what is vaginal atrophy[3], you’ll find that they don’t call it vaginal atrophy. Instead, they call it “genitourinary syndrome of menopause (GSM) when it occurs in menopause.

Who is at risk of getting vaginal atrophy?

Women who have lower levels of estrogen are more prone to develop vaginal atrophy. This is because estrogen affects the vaginal tissues, keeping them plumped up and full. Less estrogen creates a decline in the tissues, and they begin deteriorating and showing signs of aging.

Women need not be in their 50s for the loss of estrogen to begin occurring in the tissues. If they have early menopause or have had a hysterectomy, their estrogen levels will be low in a few months, and they may begin experiencing symptoms of vaginal atrophy. They find out earlier in life about what is vaginal atrophy. Their situation is often why estrogen creams may be prescribed. However, there are other more natural options.

Likewise, taking birth control pills that lower estrogen or raise progesterone levels and medications that lower estrogen levels such as drugs for cancers of the reproductive tract may predispose a woman to develop vaginal atrophy.

Other than these, immune system disorders, breastfeeding, and cigarette smoking can also decrease estrogen levels that lead to vaginal atrophy. Doctors in Greece at the University of Heraklion reported in their medical journal report that cigarette smokers go into menopause two years earlier than those who don’t smoke, and smoking affects the vaginal epithelial cells[4] negatively.

How common is vaginal atrophy?

The Cleveland Clinic[5] states on its website that at least half of menopausal women show vaginal atrophy. A 2019 multicenter cross-sectional investigation on 747 Italian women between the ages of 40 and 55 found that the prevalence ranged from:

  • 19.2% of women aged 40-45 years old
  • 53.8% of women aged 52-55 years old

However, in one Iranian study[6], researchers stated that around 90% of postmenopausal women suffer from vaginal atrophy. And one thing is sure: women who still have regular periods don’t ask the question, what is vaginal atrophy.

There may also be a cultural difference in how common atrophy is as women age, primarily related to the number of phytochemicals from plant consumption and foods in the diet. The greater the level of plants in the diet along with a wide spectrum of phytochemicals that a woman has, the longer someone stays healthy.

What causes vaginal atrophy?

There are four main times when vaginal atrophy may decrease a woman’s quality of life:

1. During breastfeeding

Right after a woman gives birth, her estrogen levels are low. These low levels last for a few months but persist during breastfeeding.

2. After menopause

In menopause, estrogen levels are not being produced as they were during the child-bearing years. These low levels persist during the rest of the woman’s life.

3. After chemotherapy, pelvic radiation therapy, or hormonal treatments for cancer

These types of treatments usually result in lower levels of estrogen, or they purposefully suppress estrogen in the body. This is how they end up ‘creating’ atrophy of the vaginal tissues.

4. After the removal of the ovaries

Women who have had removal of their ovaries are also at risk for developing vaginal atrophy. This is because the ovaries normally produce estrogen, and when removed, the primary source of estrogen is gone. Smaller amounts of estrogen may be produced in the adrenals.

What are the symptoms of vaginal atrophy?

The main symptoms according to Princeton University Ob/Gyn[7] are:

Vaginal dryness was the most prevalent symptom[8], found in 64% of the women, according to one study.

Atrophy means the withering away of tissues. Another term used regarding this condition is atrophic vaginitis. Atrophic vaginitis[9] is the vagina getting into a state of atrophy.

How is vaginal atrophy diagnosed?

A pelvic exam that views your cervix and vagina is the way that doctors diagnose the condition. Although signs such as the following are enough to make the diagnosis, a tissue sample will show fewer cells and fewer layers of cells in the vaginal tissue:

  • Vagina is white in color
  • Labia has decreased in size
  • Redness in the vulva or in any vaginal areas
  • Minor lacerations near the opening of the vagina
  • Changes in the flexibility of the tissues
  • Changes in the size of the vagina

The signs coincide with the tissue sample of what’s happening in the vaginal tissue.

What are the treatments for vaginal atrophy?

Treatments for vaginal atrophy

Doctors believe a personalized and tailored approach is needed for those with vaginal atrophy[10]. Medical treatments for vaginal atrophy include:

  • vaginal hormonal creams[11]

  • vaginal rings with estrogen
  • vaginal tablets with estrogen
  • laser treatment called the Mona Lisa Touch®[7] Treatment, which causes tissues to remodel themselves and get thicker, and Kegel exercises which bring additional blood flow to the area

A German company called BTL[12] also makes a treatment modality called Emsella that could help alleviate vaginal atrophy. A woman sits on a device that exercises the muscles of the pelvic floor for her, aiding incontinence, vaginal dryness, and lack of blood supply to the area. The treatment has a 94% satisfaction rate for incontinence, which often accompanies vaginal atrophy.

On the alternative side of treatment, one study found that a 5% fenugreek vaginal cream[13] significantly improved vaginal atrophy symptoms in a double-blind clinical trial with 60 postmenopausal women in Iran. Another study of 70 menopausal women utilizing 2% licorice vaginal cream for eight weeks showed a 28% improvement in the maturation of vaginal cells. The scientists concluded that it could be used as a natural vaginal cream for atrophy[14] of the vagina.

In another study of 96 postmenopausal women with vaginal atrophy, a gel containing 400 IU oxytocin[6] was inserted vaginally by women nightly for eight weeks. At the end of the study, 88.6% of the women using the gel did not show severe symptoms of vaginal atrophy.

Other studies show that vitamin D supplementation is helpful when taken in high doses orally (40,000-60,000 IU/wk) or used as a 1000 IU/day vaginal suppository[15].

Natural oils such as coconut oil or olive oil may also be used as a lubricant or moisturizer for the vaginal area but they can be messy and stain bedding. These oils would not necessarily address all symptoms of the atrophy.

However, all these treatments have their downside to them, and it may be easier to use herbal supplements that can address the problem more holistically. The decrease in estrogen that older women have affected many cells in the body, not only the vaginal cells, and the herbs can thus be potentially more effective. However, herbal creams can be messy and a bother to apply.

For example, Zenofem is one of the supplements put together for the purpose of enhancing sexual function via herbs that also affect other parts of the body. Zenofem is an oral supplement that supports the female reproductive tract.

Can vaginal atrophy be prevented?

Medical doctors believe that vaginal atrophy cannot be prevented. However, this is because of their training and pharmaceutical mindset. Their goal for human health is rarely to reverse disease but rather to keep it from progressing. This style of thinking prevents someone from going to the root of a condition and addressing it outside the usual box of thinking.

The questions to ask yourself for prevention are these:

  • If a lack of estrogen is linked to the condition, then how would estrogen help?
  • If adding estrogen to the body via medications has been linked to potential harm, then is this still true with local creams? If so, then what is a more natural way to put estrogen back in?
  • If certain herbs are found to support the functioning of the vagina, why shouldn’t they be considered?
  • Are there any conditions where these natural herbs would not be recommended, and is the reason a true threat or an imagined threat of something that ‘might’ happen?

Although there are many women who experience the condition, there are many who do not. If more research was done on the women who don’t have the condition, prevention can likely be determined.

Symptoms of vulvar atrophy

Frequently Asked Questions

Vulvar atrophy is usually referred to as the same thing as vaginal atrophy. The word “vulvar” refers to the vulva, the external genitals. The vagina is the internal genitals. In vulvar atrophy, the external genitalia usually decrease in size and the shape of the vagina changes size as well.

Studies have shown that different treatments with herbs reverse the disorientation of the cells in the vaginal tissues, making them appear more like those found in younger women. Since this seems to be the underlying issue with vaginal atrophy, it appears that vaginal atrophy is somewhat reversible.

Vaginal atrophy feels like your vagina isn’t working as it should, and that it doesn’t want to be bothered by sexual relations anymore. For those who have personal relationships where sex is important, vaginal atrophy can be devastating. This is one of the reasons why you’ll want to try to do something about it.


Sexual health is an important part of life. But as we age, our cells and tissues change often without us realizing what’s happening. When it starts happening to our reproductive tract as women, then that’s when we start asking the question what vaginal atrophy is. It’s the cells in this area starting to age faster and bring about changes that cause atrophic vaginitis symptoms.

This doesn’t mean it’s the end of your sex life – and your relationship forever. One of the best solutions that makes a lot of sense is the use of herb formulas such as Zenofem which support the reproductive tract. These types of formulas utilize herbs that have been shown to affect the cells in positive ways.