What is vaginal atrophy?

What is vaginal atrophy?

Vaginal atrophy affects up to 1 in 3 women and is a common symptom of menopause, yet too few women are aware of vaginal atrophy (VA), the symptoms, causes, and how your diet and supplements can help relieve symptoms. 

VA is also one of the symptoms of menopause that can have the greatest effect on quality of life - learn more in 'The mental health effects of menopause' and listen to real women discussing VA and other symptoms of menopause in our 'Menopause Roundtable' hosted by Sarah Parish

What is vaginal atrophy?

Vaginal atrophy is the thinning, inflammation and drying of the vaginal wall. The main cause of vaginal atrophy is a lack of oestrogen. This can also be called ‘genitourinary syndrome of menopause’ or GMS, because it mostly occurs after the menopause and can also affect the urinary system as well as triggering urinary tract infections, and the need to frequently urinate. You may also hear the same condition called 'atrophic vaginitis' which literally means 'shrinking of the vagina'.

Learn more about the 'Most common symptoms of menopause' and '8 unusual symptoms of menopause'.

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What causes vaginal atrophy?

The cause of vaginal atrophy is a lack of or decrease in oestrogen. Oestrogen is required for the thickness, function, moisturisation, elasticity and integrity of the vagina.

Oestrogen may be reduced for a number of reasons, including:

  • After the perimenopause and menopause
  • After the removal of both ovaries
  • During breastfeeding
  • Taking some forms or hormonal contraceptives
  • After pelvic radiotherapy
  • As a side effect of chemotherapy & hormone therapy for breast cancer

If you're experiencing bacterial vaginosis or frequent urinary tract infections, this may be due to an imbalance in your vaginal microbiome. Learn more about 'How your gut and vagina are connected'. 

Symptoms of vaginal atrophy

Common symptoms of vaginal atrophy include any number of the following:

Who is affected by vaginal atrophy

The majority of women who suffer from vaginal atrophy are going through peri-menopause, menopause or are post-menopausal.

A small number of breastfeeding women, and some women who are taking birth control pills with a level of oestrogen may also suffer from vaginal atrophy. Those who do not engage in regular sex may also be at risk.

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Other women who are affected by vaginal atrophy are those undergoing chemotherapy, with low ovarian function or no ovaries, and those with immune disorders and those who smoke.

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Vaginal pH balance

Vaginal atrophy is also associated with a higher pH. The normal pH of the vagina is less that 4.5, however a pH of 4.6 or more is associated with vaginal atrophy. This pH can make the vagina more susceptible to infections such as bacterial vaginitis and yeast vaginitis.

Best diet for vaginal atrophy

A healthy diet is essential for women with vaginal atrophy. Some foods are rich in phytoestrogens which are oestrogen compounds found in plants (plant-based oestrogens).

Phytoestrogens can trigger oestrogen receptors on cells in the body and relieve common and unusual symptoms of the menopause, and are beneficial for women with vaginal atrophy as they reduce symptoms associated with the loss of oestrogen, helping regulate hormones, particularly during menopause. 

Foods rich in phytoestrogens include flax seeds (also excellent for your skin), soya beans, sesame seeds, garlic (great for your immunity), berries and cruciferous vegetables. Consuming some of these each day can make a real difference to symptoms associated with oestrogen deficiency. 

Learn more about the best foods for menopause in 'Nutrition for the menopause'. 

Staying hydrated and consuming healthy fats is also important for the health of the vagina. Drink at least 2 litres of water per day and avoid caffeine and alcohol which are both dehydrating. The vagina relies on the proper hydration of the body and essential fats, including omega 3 fatty acids, for its integrity and moisturisation.

Understand your diet and see what it may be missing with our free online Diet Profile

Supplements for vaginal atrophy

Vitamin D

Also known as 'The Sunshine Vitamin', Vitamin D is beneficial for women who need a little more vaginal lubrication. One study found that Vitamin D supplementation results in better vaginal health. It is always a good idea to get a Vitamin D test from your doctor to ensure you take the right dose.

Omega 3

Omega 3 fatty acids are essential for the health of the vaginal membranes. Omega 3 maintains the moisturisation of cells and aids their flexibility. One study showed that Omega 3 supplementation was associated with positive changes to the vagina in women with vaginal atrophy.


Having gut-friendly bacteria in your gut is essential for the health of the vagina. The bacteria in the colon spreads to the vagina and populates it. This is excellent if the bacteria in the gut is friendly bacteria. However, those with bad or unfriendly bacteria, fungi or parasites in their colon may be prone to vaginal infections. Learn more in 'What are probiotics'.

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Probiotics can be very helpful for a number of reasons. Not only do they help to prevent infections commonly seen in women with vaginal atrophy, probiotics also produce multiple substances belonging to a category called 'short chain fatty acids' which also moisturise the vagina.

You may also be interested in 8 unusual symptoms of menopause, or discover more of our nutritionists blogs on women's health here

Discover our range of vegan probiotics, vitamins and supplements.

Watch highlights of our 'Menopause Roundtable' hosted by Sarah Parish

We also recommend the 'Menopause Help: Before, During, After' book by @clipboardclaire as an excellent guide on understanding symptoms of menopause and ideas on how to transition smoothly during through menopause.

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