Vulvar Pain and the Menopause Transition

“Shifting levels of hormones—especially oestrogen—during the menopause transition produce changes in a woman’s body. Both the vagina & the external female genitals (vulva) are affected” [1]. When this happens, it is important to visit a Vulva Pain Specialist, who can help you ameliorate the pain, & get you back on track to having an optimum sex life

What is Vulvovaginal Atrophy?

When used medically, the term ‘atrophy’ refers to: a reduction in size, or wasting away of a body part or tissue. If a Vulva Doctor talks about vulvovaginal atrophy, then it relates to the tissues of the vulva and the lining of the vagina becoming drier, thinner, and less flexible or elastic. – A condition which is often brought about by the body producing less oestrogen during perimenopause [1].

 “Vaginal secretions are reduced, resulting in decreased lubrication.  Reduced levels of oestrogen also result in an increase in vaginal pH, which makes the vagina less acidic, just as it was before puberty” [1]

Prior to menopause, a woman’s vagina has a good supply of oestrogen. Moreover, their vagina lining has more folds and is thicker, thus enabling it to stretch during childbirth, and when having sexual intercourse. Moving on to the post-menopause years, oestrogen levels become low, and the vaginal lining becomes thinner and has fewer folds. And this renders it less flexible [1].

Did You Know?

“Fragile vulvovaginal tissues are susceptible to injury, tearing, & bleeding during intercourse or any penetration of the vagina. The resulting discomfort can be so great that the woman avoids intercourse & the condition worsens. Sometimes, even women who are not sexually active are bothered by vaginal dryness & the irritation that may accompany it” [1]

Use it or Lose it!

This advice is often used by sex specialists and Vulva Pain Specialists. This is because if a post-menopausal woman does not have regular vaginal sexual activity (through intercourse, or the use of a vaginal vibrator or other such aid), then her vagina can transform to become narrower and shorter. – Generally speaking, this scenario means that during intercourse, even if she applies lubricant, she is likely to feel some level of pain [1]. To that end, when you have a consultation, your Vulva Pain Specialist will discuss various options to negate this most unwelcome dilemma. Moreover, after reviewing your medical history, and conducting any necessary tests, the Vulva Doctor will devised a Holistic Personalised Treatment Plan, which you can get started on right away.


[1]. The North American Menopause Society (2023). “Changes in the vagina and Vulva.”