What causes vaginal atrophy (atrophic vaginitis)?
Table of Contents
Key takeaways
- This rewrite is classified as menopause and focuses on the reader's practical question.
- Do not rely on a single symptom or online description for diagnosis; context and examination may matter.
- Treatment options may help, but suitability should be confirmed by an appropriate clinician.
- Use NHS 111 for urgent advice if symptoms are severe, sudden or worrying. Call 999 in a life-threatening emergency.
Overview
The usual driver is lower oestrogen after menopause, during perimenopause, after some cancer treatments, while breastfeeding or with some medicines. Lower oestrogen changes tissue thickness, lubrication, blood flow and vaginal pH.
Why it happens
Lower oestrogen can reduce collagen, elasticity, blood flow and natural lubrication in vulval and vaginal tissues. The vaginal microbiome and pH can also change, which may contribute to irritation and urinary symptoms.
Assessment and treatment
A clinician may discuss menopause stage, medicines, cancer history, urinary symptoms, discharge, bleeding and sexual pain. Options may include vaginal moisturisers, lubricants, local hormone treatment, pelvic floor care and review of other causes.
Daily care
Avoid perfumed washes, douching and harsh soaps around the vulva. Use a simple emollient as advised, choose comfortable fabrics and use lubricant for sex if dryness or friction is a trigger.
When to seek medical advice
Seek medical advice for post-menopausal bleeding, bleeding after sex, persistent discharge, recurrent urinary infections, severe pain or symptoms after cancer treatment. Use NHS 111 for urgent advice if symptoms are severe, and call 999 in an emergency.
Sources
- NHS, Vaginal dryness: https://www.nhs.uk/symptoms/vaginal-dryness/
Relevance: NHS explains symptoms, causes, self-care and treatment routes for vaginal dryness. - NICE NG23, Menopause identification and management: https://www.nice.org.uk/guidance/ng23/chapter/Recommendations
Relevance: NICE supports assessment and management of menopause symptoms, including genitourinary symptoms and local hormone options. - NHS, Menopause: https://www.nhs.uk/conditions/menopause/
Relevance: NHS explains menopause-related hormone changes, symptoms and when to seek support.
Disclaimer
Educational only. Results vary. Not a cure. Use NHS 111 for urgent advice if symptoms are severe, sudden or worrying. Call 999 in a life-threatening emergency.







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