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Vaginal Atrophy | Vaginal Dryness

Natural Help & 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. Your vaginal walls may become fragile, prone to tearing and bleeding, especially after intercourse. The skin around your vaginal opening can be sore and itchy. You might see a discharge and suffer from frequent infections like bacterial vaginosis and yeast infections. Some women experience pelvic pain.

Since your reproductive and urinary systems are interconnected, vaginal atrophy can cause recurrent UTIs and frequent urgent urination. You might leak urine when you laugh or sneeze. You may struggle to reach the toilet in time and feel pain or burning when you urinate.

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

How can Vaginal Atrophy Affect Mental Health?

The physical effects of vaginal atrophy can be debilitating. Over a quarter of sufferers said their symptoms interfered with their overall quality of life. Almost one-third of women reported that the condition caused problems sleeping. More than half said it interfered with their ability to be intimate.

Many women with vaginal atrophy experience depression, anxiety, poor self-esteem, and problems with intimate relationships. This makes it incredible that vaginal atrophy is not widely discussed.

The symptoms of vaginal atrophy can mimic other conditions. It’s important to get checked by a medical professional if you suspect you’re affected. However, many women are embarrassed to seek help because of the intimate nature of the problem. Some believe it’s an inevitable effect of growing older.

How is Vaginal Atrophy Connected to Vulvodynia?

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

Vulvodynia causes pain when you sit or wear tight clothing. Sometimes the pain is constant, seriously interfering with quality of life. Some women are even forced to give up jobs requiring long periods of sitting 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 monthly, as your body doesn’t need to prepare for pregnancy. Initially, hormones fluctuate, causing familiar menopause symptoms like night sweats and headaches.

Once these symptoms settle, you enter the postmenopausal phase. Hormone levels, particularly oestrogen, naturally fall. Oestrogen’s role during your fertile years is to build up your womb lining for conception, so your ovaries don’t produce 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 stop.

Oestrogen is crucial for your vaginal health, keeping its wall cells lubricated and healthy. When oestrogen levels decline in your vagina, the lining becomes thinner and dryer, leading to inflammation. This causes the typical discomfort and burning in your vagina and vulva associated with vaginal atrophy.

Collagen provides support and structure to tissues, including your vaginal walls. Oestrogen plays an important role in collagen formation. When oestrogen declines, your vagina becomes less elastic, similar to how post-menopausal collagen decreases in your facial skin cause wrinkles.

What is the Vaginal Microbiome?

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

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

The dominant bacteria in healthy women’s vaginal microbiome are known as Lactobacillus. These 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, vaginal pH often rises, becoming more alkaline, partly because oestrogen helps keep the vagina acidic. The naturally occurring Lactobacillus bacteria can’t thrive as well, while yeasts like Candida multiply. This makes you more likely to suffer from infections and UTIs.

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 this way keeps it in the area rather than circulating throughout your body. This is important because excessively high oestrogen levels, like low levels, have negative effects. Too much oestrogen in the body has been linked to breast and uterine cancers.

Women’s bodies are designed by nature to change after menopause, so some argue that replacing hormones to pre-menopausal levels is unnatural. However, society has changed too. Women are living longer, staying active into older age, and rightly expect to maintain intimate relationships after menopause. Many women find their quality of life greatly improves by supporting hormone levels.

There’s also a significant difference between replacing hormones with synthetic copies, which the body has difficulty handling, and using hormones identical to those produced by your body.

Does Oestrogen Cream help Vaginal Atrophy?

If your vagina lacks 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. 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 much weaker than the oestrogen your body produces but can still gently support oestrogen levels without pushing them too high. These naturally occurring plant oestrogens are known as isoflavones. Including foods rich in these substances in your diet can help boost low oestrogen levels and alleviate vaginal atrophy.2

Isoflavones are found in legumes such as chickpeas, nuts, and seeds, especially flax seeds. However, the richest source of isoflavones is fermented soya products such as tempeh and miso. Some women find supplements containing isoflavones from red clover helpful.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. 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 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 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 gently and painlessly stretch the walls of your vagina, improving elasticity. A physiotherapist who specialises in pelvic health can help tense muscles in the area relax, aiding blood flow.

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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