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Vaginal Atrophy – Natural Help and Support with Functional Medicine


Vaginal Atrophy and Treatment with Functional Medicine

What is Vaginal Atrophy?

Vaginal atrophy affects as many as half of all post-menopausal women. Although the symptoms of menopause like night sweats, anxiety, depression and memory issues are being discussed more and more, vaginal atrophy is barely mentioned. In fact, many women have never heard of it. This means women who are affected often feel very alone, and the severity of their symptoms take them by surprise.

Vaginal atrophy is sometimes thought of as vaginal dryness, but the term ‘dryness’ implies a huge underestimation of the problem. It’s a collection of symptoms arising from changes in the vagina, the external vulva, and the urinary tract. It usually, although not always, happens after menopause. Vaginal atrophy goes by the other names of atrophic vaginitis and genitourinary syndrome of menopause or GSM.

If you are past the menopause and you have noticed your vagina becoming dry, itchy and uncomfortable, chances are you’re affected by vaginal atrophy. Don’t suffer in silence – it’s time to bring vaginal issues out into the open.

Read on to discover why vaginal atrophy develops and what you can do to help yourself.

What are the Symptoms of Vaginal Atrophy?

Symptoms of Vaginal Atrophy

One of the first signs is a dry, uncomfortable vagina, making sex difficult and unappealing. The walls of your vagina may become fragile and liable to tear and bleed, especially after intercourse. The skin around your vaginal opening can be sore and itchy. You may see a discharge, and find you’re suffering from frequent infections like bacterial vaginosis and yeast infections. Some women experience pelvic pain.

Because your reproductive and urinary systems are interconnected, vaginal atrophy can lead to recurrent UTIs as well as a frequent need to urinate urgently. You might leak urine when you laugh or sneeze. You may find you can’t make it to the toilet in time, and feel pain or a burning sensation when you urinate.

Over time, your vaginal canal may contract and shorten, making sex uncomfortable or impossible. This may cause vaginismus, when the muscles around the opening of the vagina involuntarily constrict, making penetration difficult or uncomfortable. This can sometimes be related to the fear of painful intercourse, setting up a vicious cycle.

How can Vaginal Atrophy Affect Mental Health?

The physical effects of vaginal atrophy can be debilitating, with over a quarter of sufferers surveyed saying their symptoms interfered with their overall quality of life. Almost one-third of women said the condition caused problems sleeping, while over half said it interfered with their ability to be intimate.

Not surprisingly, many women with vaginal atrophy experience depression, anxiety, poor self-esteem, and problems with intimate relationships as a result. This makes it all the more incredible that vaginal atrophy is not widely discussed.

Because the symptoms of vaginal atrophy can mimic other conditions, it’s important to get checked out by a medical professional if you suspect you’re affected. However, many women are embarrassed to seek help, because of the intimate issues surrounding the problem, or they put it down to an inevitable effect of growing older.

How is Vaginal Atrophy Connected to Vulvodynia?

As vaginal atrophy develops you might experience the symptoms of vulvodynia. This means chronic pain or discomfort around the opening to your vagina, called the vulva. Strictly speaking, vulvodynia is pain without a discernible cause, and can affect younger women too.

Vulvodynia causes pain when you’re sitting or wearing tight clothing, although sometimes the pain is constant, seriously interfering with quality of life. Some women are even forced to give up employment which requires sitting for any length of time, and can no longer wear their favourite clothes.

What Causes Vaginal Atrophy?

After menopause, women’s hormone levels naturally change. Once you stop having periods, you no longer produce female hormones in a monthly pattern, because your body doesn’t need to prepare for pregnancy. Initially, hormones fluctuate giving rise to the familiar symptoms of menopause like night sweats and headaches.

Once these settle down, you’ll enter the postmenopausal phase. Hormone levels, in particular oestrogen, naturally fall. Oestrogen’s role during your fertile years is to build up your womb lining in preparation for conception, so your ovaries don’t manufacture it in the same quantity. However, your body still needs a little oestrogen after menopause. It protects your bones and supports your heart, so your fat cells continue to produce some after your periods have stopped.

Oestrogen is also extremely important for the health of your vagina, keeping the cells in its wall lubricated and healthy. If the oestrogen levels in your vagina decline, over time the lining will become thinner and dryer and you’ll experience inflammation. Cue the typical discomfort and burning in your vagina and vulva associated with vaginal atrophy.

Collagen has the job of providing support and structure to tissues including the walls of your vagina. Oestrogen plays an important role in collagen formation and when oestrogen declines, your vagina becomes less elastic than it was in your reproductive years, in the same way a post-menopausal decrease in collagen in the skin of your face causes wrinkles.

What is the Vaginal Microbiome?

The word microbiome refers to a collection of bacteria living in your body. They perform useful roles, combatting inflammation, for example. The most well-known microbiome is the one in your gut, however, you have microbiomes in other places too. You have a microbiome in your mouth, on your skin, and in your vagina, where the bacteria colonise the mucus membrane on the surface of the lining.

There are many different species of bacteria able to colonise the vaginal microbiome, and yours is as unique as your fingerprint. A healthy population of bacteria prevents the growth of disease-causing microbes and produces organic acids to balance the vaginal pH. The bacteria in this area prefer to live in a slightly acidic environment.

The dominant species of bacteria in the vaginal microbiome of healthy women is known as Lactobacillus. These types of bacteria tend to decline at menopause 1. Other, less beneficial species then come to dominate, increasing the risk of developing vaginal atrophy. Any imbalance in the bacteria can cause inflammation in your vagina.

After menopause, the pH in the vagina often rises, becoming more alkaline, partly because oestrogen helps to keep the vagina acidic. The naturally occurring lactobacillus bacteria can’t then thrive as well, while yeasts such as candida take the opportunity to multiply. All this means you’re more likely to suffer from infections and UTIs, too.

What are the Usual Treatments for Vaginal Atrophy?

Many women find applying topical oestrogen in the form of a cream to the vagina helpful. Experts believe applying oestrogen in this way means it remains in the area rather than travelling around your body. This is important because just as low oestrogen levels have negative effects, so do excessively high levels – too much oestrogen in the body has been linked with cancers of the breast and uterus.

Women’s bodies are designed by nature to change after the menopause, so many people argue that replacing hormones after menopause to the same levels found during women’s fertile years is unnatural. However, society has changed, too – women are living longer, are more active into older age and rightly expect to maintain intimate relationships after their menopause. Many women find their quality of life greatly improved by supporting hormone levels.

There’s also a world of difference between replacing hormones with synthetic copies which the body has difficulty handling, and using hormones identical to the ones produced by your body and recognised accordingly.

Does Oestrogen Cream help Vaginal Atrophy?

If your vagina is lacking oestrogen, restoring healthy levels in its walls can support collagen production and re-establish a healthy vaginal pH. Many women find topically applied oestrogen cream can significantly reduce vaginal atrophy. Generally, the cream is applied at night, daily for the first two weeks, then two to three times weekly. 

Studies have shown low doses of oestrogen are most effective at improving collagen production and increasing vaginal elasticity, so in oestrogen’s case, less is definitely more.

What Natural Support is Available for Vaginal Atrophy?

Some foods contain substances capable of mimicking oestrogen. They’re many times weaker than the oestrogen your body produces, but they’re still able to gently support oestrogen levels without pushing them too high. These naturally occurring plant oestrogens are known as isoflavones. So, including foods rich in these substances in your diet can help boost low oestrogen levels and alleviate vaginal atrophy 2.

Isoflavones are contained in legumes such as chickpeas, nuts and seeds, especially flax seeds. However, by far the richest source of isoflavones are fermented soya products such as tempeh and miso. Some women find supplements containing isoflavones from an extract of red clover can help 3.

Healthy bacteria in the gut are needed to release the isoflavones from food sources. Fermented foods like kefir, kimchi, sauerkraut and kombucha can help encourage a healthy gut microbiome. Avoiding sugar denies unhealthy inflammation-causing bacteria their food source.

Probiotic supplements with specific strains of bacteria known to colonise the vagina can be taken orally to help re-establish a healthy gut microbiome. This will then have a knock-on effect on the bacteria in your vagina. However, short courses of probiotic pessaries designed to be inserted into your vagina are also available.

A natural aloe vera or cocoa butter vaginal moisturiser can be useful to restore lubrication to the vaginal walls, although these won’t address any underlying hormone imbalance so their effect will be temporary. Many women find vitamin E oil applied topically to the vagina is very soothing 4.

It’s a good idea to avoid bath and shower products containing artificial chemicals because these can irritate sensitive tissues. Natural undyed cotton underwear is recommended, as well as avoiding tight-fitting trousers.

Regular sexual activity increases blood flow to your vaginal area, keeping tissues healthy and retaining elasticity. Physical exercise can boost blood flow, too.

If your vagina has shortened and become narrow, regular use of a dilator can help gently and painlessly stretch the walls of your vagina and in turn improve elasticity. You may find a physiotherapist who specialises in pelvic health can gently help tense muscles in the area to relax, aiding blood flow.

Do talk to your partner about your concerns, because of the inevitable effect of your condition on intimate relationships.

Can Functional Medicine Help with Vaginal Atrophy?

Functional medicine looks at you as a whole person with all your organs and systems in constant communication, each affecting the others. It considers you as an individual, so a consultation will include a detailed case history to establish how you have arrived at your current state of health. Functional tests, for example a urine test to see how your body is dealing with oestrogen, take the guesswork out of what’s causing your symptoms. A simple vaginal swab can assess the health of your vaginal microbiome, discovering the types of bacteria resident there as well as the pH of your vagina.

Then, a combination of nutritional, supplement, and lifestyle strategies, personalised to you, will be recommended to correct the imbalances in your body responsible for your symptoms. Of top priority will be to restore your vaginal microbiome and balance your hormones.

I offer one-to-one nutritional and lifestyle consultations to naturally overcome vaginal atrophy and will support you every step of the way. Contact me today to start your journey to optimal vaginal health.

Use my code Gamble10 for a 10% discount on any product purchased through the Natural Dispensary.



  1. Association of Vaginal Microbiota With Signs and Symptoms of the Genitourinary Syndrome of Menopause Across Reproductive Stages – PubMed (nih.gov)
  2. Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis | Complementary and Alternative Medicine | JAMA | JAMA Network
  3. An overview of the phytoestrogen effect on vaginal health and dyspareunia in peri- and post-menopausal women – PubMed (nih.gov)
  4. A survey of the therapeutic effects of Vitamin E suppositories on vaginal atrophy in postmenopausal women – PubMed (nih.gov)



Our practitioner for Natural Support for Vaginal Atrophy is :

Rebecca Wakefield Nutritional Therapist

Rebecca Wakefield

Functional Medicine Trained Nutritional Therapist

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