9 Sneaky Symptoms of Vaginal Atrophy

by Sheila M. Eldred Health Writer

If you have vaginal atrophy (VA) and experience symptoms, then you probably know all too well the common ones—pain during sex, itchy genitals, a burning sensation in your vagina. But did you know that VA can affect much more than that, causing a variety of other symptoms including urinary-related issues, a reason it was renamed genitourinary syndrome of menopause (GSM)? To find out about some sneaky symptoms you might not have suspected as being VA/GSM related, read on.

E. Coli

You Have More Than Your Fair Share of UTIs…

Even though urinary tract infections (UTIs) are more common with age—just like VA/GSM— the underlying causes of these infections aren’t always identified. In younger women, sexual intercourse is the most common cause of UTIs. In older women, anatomic changes that happen during VA are one of the top causes. Why does it matter? If the underlying cause isn’t identified and treated, you may go on unnecessary prescriptions of antibiotics. That’s not good for you, or antibiotic resistance.

pH balance

…And/Or You Have Recurrent Vaginal Infections You Just Can’t Kick

VA can wreak havoc with the pH of your vagina and vulva, which can lead to increased bacterial vaginitis or yeast infections, says Sheryl Kingsberg, Ph.D., chief of the division of behavioral medicine in the department of OB/GYN at MacDonald Women’s Hospital in Cleveland and past president of the North American Menopause Society. Indeed, changes in that acid balance make all types of vaginal infections more likely, according to the Mayo Clinic.


You Can’t Control When You Pee

Similarly, urinary incontinence (UI) is linked to postmenopausal women. And whether it’s the type of incontinence that makes you feel like you need to pee immediately (severe urgency) or the type where physical stress puts pressure on your bladder (stress UI), the top cause is the same. Yep, once again those anatomical changes appear to be the culprit, according to a study published in the Journal of Menopausal Medicine.

women's bathroom

You Can’t. Stop. Peeing

If you’re peeing a lot more than usual after menopause, don’t automatically chalk it up to an unrelated bladder infection, says Sherry Ross, M.D., an obstetrician-gynecologist and women’s health expert in Santa Monica, CA. It could be another symptom of VA/GSM.

talking to doctor

You're Tender A Lot of the Time

If you experience an irritated, tender, and/or burning sensation during sex, yes, that points to VA. But the same applies if you have those feelings any other time during the day. That discomfort shouldn’t be ignored, as it could signal VA or other conditions, according to the Cleveland Clinic. Best to have it checked out so you know what’s going on.

vaginal bleeding

You Have Light Vaginal Bleeding

You know something we don’t talk about enough? Vaginal bleeding. With VA, “the vagina shrinks, which can cause dryness, burning and itching, but it also changes in shape, especially if you’re not using it because of painful intercourse. That can lead to bleeding,” says Dr. Ross. How to differentiate this symptom from other causes of bleeding (like a period if you’re perimenopausal)? The minuscule tears that happen from this process in the vagina usually cause light, not heavy, bleeding, she says.

mature sex

You Struggle to Reach Orgasm

Because VA often means there’s less blood flow to the clitoris, it can make orgasms challenging, Dr. Ross says. Just one more reason to talk to your doctor about sex … even if you have to initiate the conversation, she says. It can be a tough topic to talk about, but with the right treatment, improvement in VA symptoms is possible!

mature pelvic discomfort

You Feel Spasms in Your Pelvic Region

As if painful sex (and all these other symptoms) weren’t bad enough, a condition called vaginismus can occur when you’re nervous about intercourse, causing discomfort. Vaginismus is a muscle spasm in the pelvic floor muscles—and can increase pain during sex. It’s a Catch-22 you’ll want to avoid by recognizing and treating the underlying cause.

orange vagina

Your Vagina Is Literally a Different Size

So many VA/GSM symptoms can be traced to the lack of estrogen that our bodies experience after menopause. It makes the lining of the vagina thinner and less stretchy, but it can also cause the vaginal canal to narrow and shorten, the Cleveland Clinic notes. These physical changes are a reminder that VA is chronic and progressive, Kingsberg points out. “It doesn’t get better unless you treat it,” she says. We can’t say it enough—see your doctor soon to discuss potential treatment options right for you.

Sheila M. Eldred
Meet Our Writer
Sheila M. Eldred

Sheila Mulrooney Eldred is a graduate of Columbia’s School of Journalism and a former newspaper reporter. As a freelance health journalist, she writes about everything from life-threatening diseases to elite athletes. Her stories have appeared in The New York Times, Nature, FiveThirtyEight, Pacific Standard, STAT News, and other publications. In her spare time, she and her family love running, cross-country skiing, and mountain biking in Minneapolis.