Best Ways to Prevent (and Lessen) Vaginal Atrophy

by Lucy Hicks Health Writer

Is it possible to prevent vaginal atrophy (VA), also known as genitourinary syndrome of menopause? It depends on what you mean by prevention. When women go through menopause, their bodies naturally make less estrogen, a hormone that helps maintain vaginal tissue. This can cause the vaginal wall to thin and shrink, leading to VA. But unlike other menopause symptoms—think hot flashes—these below the belt changes don’t lessen with time. Learn more about how you can prevent VA from starting—or getting worse if you already have it.

mature women talking

Don’t Be Afraid to Talk About It

While preventing VA entirely might not be possible because estrogen loss is a natural process, identifying symptoms early and intervening can prevent the condition from getting worse. A big first step is talking about it, and “normalizing that this is something that a lot of women are experiencing,” says Makeba Williams, M.D., an OB-GYN at UW Health in Madison, WI. While women might swap stories on night sweats and hot flashes, few talk about vaginal dryness with their friends, she says. Dr. Williams discusses VA with her patients even before they enter menopause: “It’s beginning to start that conversation.”

cigarette in ashtray

Stop Smoking

It is common knowledge that smoking can lead to cancer and heart disease, but did you know, smoking can also increase your chances of developing VA? Nicotine, the addictive chemical in tobacco products, affects the circulatory system and may slow blood flow to tissues, including the vagina. Smoking can also reduce the beneficial effects of estrogen, leading to irritation, dryness, and other symptoms associated with VA. As if you needed another reason to quit!

mature sex

Have Sex With a Partner

Turns out, sex is good for you, in more ways than one, says Mary Jane Minkin, M.D., a gynecologist at the Yale School of Medicine in New Haven, CT. And it might just be the ticket to preventing, or lessening the impact, of VA. Having regular sex increases pelvic blood flow, which can help keep vaginal tissue healthy and add moisture, she says. But this doesn’t mean patients should endure painful sex: Treatments can help alleviate symptoms to make intercourse more enjoyable (more on that later).


Have Sex WITHOUT a Partner

Don’t have a sexual partner or aren’t interested in having sex with someone else? A vibrator or other stimulating sex toy works just as well to increase blood flow to the pelvic area. Dilators—smooth, tube-shaped objects that stretch the vagina—can also be useful to help keep tissue more elastic, says Dr. Williams. The vaginal channel can shorten and narrow during menopause, and using a dilator can help maintain its shape.

mild soap

Avoid Irritants

If you are already experiencing dryness, using a gentle, unscented soap to wash your vaginal area can prevent VA from worsening, says Dr. Minkin. Fragrant soaps, bubble baths, lotions, or other products with perfumes can irritate this already sensitive area. Avoid douching, as it can increase dryness. It can also disrupt the balance of bacteria in the vagina, making you more vulnerable to urinary tract infections.

cotton panties

Get Some Air Down There

While underwear choice won’t prevent you from developing VA, choosing breathable fabrics can help ease irritation, says Dr. Williams. Synthetic materials can agitate sensitive areas and trap sweat, increasing the risk for infection, so she advises patients to stick to cotton underwear. At night, considering going commando to let the area breathe. Avoid wearing pads and pantiliners every day, as they can cause friction and irritate the skin.

blister pack

What Treatments Are Available?

We just want you to know, if you do develop VA, there are plenty of therapies to treat it. Using over-the-counter moisturizers a couple of days a week can rehydrate vaginal tissue, and using lubricants can help alleviate pain during sexual activity. But the most effective treatment addresses the cause of the condition: The loss of estrogen, says Heather Hirsch, M.D., a physician at the Brigham and Women’s Hospital Menopause & Midlife Clinic in Boston, MA. Hormone therapy not only treats symptoms of VA but can also help restore affected tissue and maintain a healthy PH balance in the vagina.

physical therapist

Consider Therapy for Your Pelvic Floor

Pelvic floor physical therapy (PT) can also help lessen VA symptoms like pain during sex, and prevent progression. This type of PT goes beyond regular Kegels to focus on restoring strength and function to the muscles that support the pelvis, like your hip flexors and core, Dr. Hirsch. And exercises designed to relax muscles can sometimes be more helpful to patients than just tightening exercises alone, she says. These exercises can also help treat urinary problems that come along with VA, like bladder leakage.

woman laying down breastfeeding

Be Aware of Other Risk Factors

Though women going through menopause are at the most risk for VA, younger women can also develop this condition. The body dials down estrogen production while breastfeeding, which can put mothers in a “menopause-like state,” says Dr. Minkin, which can lead to dryness and irritation. Chemotherapy or radiation for pelvic cancers can have a similar effect, as these treatments can impact the normal functioning of the ovaries, which produce estrogen. By being aware of your risk factors, you can identify and treat the condition to prevent it from worsening.

Meet Our Writer
Lucy Hicks