Menopause and vaginal discomfort
Vagina pain and vaginal discomfort during menopause can make life challenging whether you are at work or trying to sleep. It can also have an impact on your sex life and relationships. You might feel awkward talking about it to your doctor or your friends, but feel reassured that these symptoms are very common. The good news is these menopause symptoms are treatable.
VAGINAL DISCOMFORT DEFINITION
Vaginal discomfort during menopause includes vulvovaginal and urinary symptoms, such as burning, dryness, itching and vaginal soreness. You might experience one or a combination of these symptoms.
- Vaginal burning: The sensation of tingling and burning in your genital area can be hard to ignore. It can be even harder to find a comfortable position. It’s generally an indicator of other vaginal issues that may happen during menopause, such as urinary tract infections (UTIs) or vaginal irritation (vaginitis)
- Vaginal dryness: This can happen due to hormonal changes during menopause, which affect the moisture level in your vagina
- Itching: This can be hugely uncomfortable and sometimes quite painful. Itching happens due to declining oestrogen levels during menopause, which can lead to vaginal atrophy (thinning and drying of the vaginal walls)
- Vaginal soreness: This can include any of the above symptoms, as well as inflammation, a throbbing feeling, and puffiness of your labia
Start your free online menopause assessment to see if HRT is right for you
HOW LIKELY IS VAGINAL PAIN DURING MENOPAUSE?
- Symptoms of vaginal discomfort and menopause pain in the genital area tend to increase during menopause. Vaginal pain can also increase postmenopause after years of low oestrogen levels
- Less than a third of those who are perimenopausal and early postmenopausal report vaginal discomfort or dryness of some sort, but up to half of those who are late postmenopausal report some form of vaginal discomfort or dryness
- Vaginal burning can occur at any point in the menopause journey, sometimes even during perimenopause or after several years of decreased oestrogen levels
- Those who have a history of diabetes and those with lower BMIs tend to be more likely to report discomfort in their vagina
Read more about the stages of menopause.
CAUSES OF VAGINAL DISCOMFORT
Urinary tract infection (UTI)
Vaginitis (inflammation of the vagina), vaginal irritation or vulvodynia (long-lasting pain in the vulva, around the opening of the vagina)
Vaginal atrophy (thinning and inflammation of the vaginal walls)
Lack of lubrication before or during sex
RELIEF FOR VAGINAL DISCOMFORT
Lubricants
These can help keep your vagina moisturised and make sex less painful. Choose water-based lubricants as they are less likely to irritate your skin further
Topical oestrogen
Talk to your doctor about your vaginal pain and they may suggest vaginal oestrogen as a pessary that you insert into your vagina, a vaginal cream or a vaginal ring. A ring pessary releases oestrogen and supports your vaginal walls.
Hormone replacement therapy (HRT)
HRT can help vaginal dryness, plus hot flushes, sweats, sleep issues and mood changes. Talk to your doctor as HRT is not suitable for everyone. Read more about the HRT debate.
Avoid irritants
Buy unperfumed bath products and skin-kind detergents.
MENOPAUSE AND VAGINA PAIN
Decreasing oestrogen levels during menopause affect vulval and vaginal tissue integrity, it becomes thinner, more fragile and sensitive.
Reduced oestrogen levels lead to less natural lubrication being produced which can lead to dryness and other sensations of discomfort.
Some women have other menopause symptoms, such as prolapse or incontinence.
Vagina pain is not life-threatening but can cause discomfort. It may impact your desire to have sex and your intimate relationships. If you previously enjoyed an active sex life, this can leave you feeling low.
It can affect your quality of life if you haven’t found treatment or support that works for you.
You may have to adapt to minimise pain. You might find you can’t wear certain clothes, like tight-fitting trousers, or ride a bike or horse.
Unfortunately, many who suffer vaginal discomfort, such as burning sensations, don’t see their doctors because they believe it’s just a normal part of ageing. This is not the case! You do not have to put up with this pain.
If you’re finding the symptoms challenging, treating them can really improve your quality of life.
Because vaginal discomfort can arise from so many different sources, persistent symptoms of dryness, irritation, burning, itchiness or pain should be checked out by a doctor.
I need to know if sex is part of my future”
- Cleveland Clinic, 8 Possible Reasons Why Your Vagina Itches
- Dennerstein L, Dudley EC, Hopper JL, Guthrie JR, Burger HG. A prospective population-based study of menopausal symptoms. Obstet Gynecol. 2000;96(3):351-358. doi:10.1016/s0029-7844(00)00930-3
- Gandhi J, Chen A, Dagur G, et al. Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. Am J Obstet Gynecol. 2016;215(6):704-711.
- Healthline: What Causes Vaginal Dryness?
- Healthline: What Causes a Sore Vaginal Area After Sex?
- Healthline: What Are the Symptoms and Signs of Menopause?
- Huang AJ, Moore EE, Boyko EJ, et al. Vaginal symptoms in postmenopausal women: self-reported severity, natural history, and risk factors. Menopause. 2010;17(1):121-126. doi:10.1097/gme.0b013e3181acb9ed
- Jin J. Vaginal and Urinary Symptoms of Menopause. JAMA. 2017;317(13):1388. doi:10.1001/jama.2017.0833
- NHS: Vaginal Dryness
Planned Parenthood: Vaginitis - The North American Menopause Society: Changes in the Vagina and Vulva
- The North American Menopause Society: Vaginal Discomfort
- Woods NF, Mitchell ES. Symptoms during the perimenopause: prevalence, severity, trajectory, and significance in women’s lives. Am J Med. 2005;118 Suppl 12B:14-24. doi:10.1016/j.amjmed.2005.09.031
