Causes of Vaginal Atrophy

Eileen Bailey | July 23, 2015 Nov 13, 2000

Reviewed by Peter J. Chen, MD, FACOG

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Vaginal atrophy is when the skin and tissues in and around your vagina become drier, thinner, and less elastic. It can cause discomfort or pain during sex as well as bladder problems, such as urinary incontinence and recurrent urinary tract infections. It can increase your risk of chronic vaginal infections and urinary tract infections.

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Vaginal atrophy is caused by a decrease in your estrogen level

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The most common reason for decreased estrogen is menopause. Menopause normally occurs sometime between the ages of 45 and 55 years old. During this time, your ovaries stop producing eggs, your period ends, and your body no longer produces as much estrogen.

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Surgical menopause

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Surgical menopause, which occurs when the ovaries are surgically removed because of disease or during a radical hysterectomy, also results in decreased estrogen levels and can lead to vaginal atrophy.

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Estrogen levels begin to drop during perimenopause. Some women begin to experience symptoms of vaginal atrophy during this time. Others will not notice any differences or symptoms until postmenopause.

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Breastfeeding can reduce your estrogen levels. Some women do experience symptoms of vaginal atrophy while lactating, but this is temporary. When you stop breastfeeding, estrogen levels will return to normal and symptoms will go away.

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Cancer treatments

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Some cancer treatments, such as pelvic radiation, some chemotherapies and hormone suppression therapy for breast cancer, lead to decreased estrogen production which can lead to vaginal atrophy.

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Other medications

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Medications used to treat endometriosis, fibroids or infertility can also reduce levels of estrogen and, therefore, lead to symptoms of vaginal atrophy.

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Solution: Have more sex?

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Not all women develop vaginal atrophy, even when estrogen levels are low. Having sex or masturbating on a regular basis may help keep genital tissues healthy.

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Treatment options

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If you are experiencing symptoms of vaginal atrophy, there are a number of treatment options. For those with mild symptoms, over-the-counter lubricants, a consistent sex life, and regular exercise might help. For those with more severe symptoms, systemic or topical estrogen replacement therapy might be needed.

NEXT: How To Be Intimate Again With Vaginal Atrophy