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Vaginal Atrophy‎

Dr. Lisa Lawless

Dr. Lisa Lawless, CEO of Holistic Wisdom
Clinical Psychotherapist: Relationship & Sexual Health Expert

Vulvar & Vaginal Atrophy‎

What Is Vaginal Atrophy?

Vaginal atrophy (atrophic vaginitis) is when the vaginal tissue becomes thinner, dryer, and inflamed. It is medically referred to as genitourinary syndrome of menopause (GSM) because most women have vaginal and urinary symptoms rather than just vaginal discomfort. It typically occurs after menopause, but it can also happen from having the ovaries removed and low estrogen levels. Because the vagina is more sensitive, it can make sexual penetration painful and cause difficulty with urination.


Menopause can cause vaginal atrophy. Women who go through menopause may find relief using moisturizing lubricants that provide added moisture to dry vaginal tissue, dilators to help stretch the vaginal walls to keep them from getting too tight, and hormone replacement therapy (HRT) which can replace estrogen in the body. For additional information about this, please see our Perimenopause & Menopause Guide.

Low Estrogen Levels

Low estrogen levels can occur in young women who exercise excessively, have very little body fat, or struggle with an eating disorder such as anorexia or bulimia. Low estrogen levels can cause vaginal atrophy by thinning and shrinking the vaginal walls.


Vaginoplasty is surgery that is performed to construct or reconstruct the vagina. It is used for cancer surgery, vaginal injuries, congenital defects, and for trans women (penile inversion surgery). The vagina will try to heal itself after the surgery and, in doing so, can begin to close up. Using dilators to keep vaginal atrophy from occurring is part of aftercare.

Cancer Treatments

Cancer treatments such as radiation, chemotherapy, endocrine tamoxifen, aromatase inhibitors, or surgery can cause vaginal atrophy. Here is how they typically affect cancer patients:

  • Radiation therapy often causes vaginal dryness and causes the vaginal canal to narrow and shorten due to radiation scarring.

  • Chemotherapy may cause a dramatic loss in estrogen, specifically in the ovaries, which causes vaginal atrophy).

  • Tamoxifen endocrine therapy attaches to hormone receptors in the cancer cells and blocks estrogen from binding to the receptors.

  • Antiestrogen therapy (aromatase inhibitors) causes vaginal itching, dryness, irritation, painful urination (dysuria), and painful sex (dyspareunia).

  • Cancer surgery can leave scarring, circumferential fibrosis (overgrowth, hardening), and the development of adhesions (when tissue heals together and becomes stuck). This can cause narrowing, shortening, and contractions of the vagina, causing vaginal atrophy.

Please also see our helpful guide on Sex With Cancer for more information. 

Vaginal Atrophy Remedies

However you choose to address vaginal atrophy, it is always best to consult with your health care provider to ensure that any products you use are well suited for your particular health condition. If you are uncomfortable talking about sexuality with your doctor, please see our helpful guide: How to Talk To Your Doctor About Sex. Being a good advocate for your health is something you deserve to do for yourself.

Below are common ways to address vaginal atrophy discomfort. If you are under the care of a healthcare provider, please feel free to suggest that they contact us as we are happy to work with your physician in helping them better understand the latest sexual health products available to their patients.

Paraben-Free Moisturizing Lubricants 

To learn more about what makes a lubricant healthy such as proper pH and osmolality levels, please see our Personal Lubricant Guide.


A dilator comes in a set of two or more special dildos designed for gently stretching vaginal tissue. They are often tapered at the end to make insertion more effortless, and some are curved for easier insertion. There are dilators with handles on them to make them easier to hold, and others have a flat base that allows the user to sit on them.

Vaginal Dilator Sets For Atrophy

Dilators should be made of a body-safe, nonporous material such as silicone, glass or metal. Please see our Body-Safe Sex Toy Guide for additional education on what makes a material safe for sexual use.

For step-by-step instructions on using a dilator, please see our Painful Sex Guide.

Kegel Exercisers

Keeping pelvic muscles strong and healthy is vital for good vaginal health. Kegel weights and exercisers can provide added strengthening and conditioning of your pelvic floor muscles; however, they are not necessary for doing Kegel exercises. Whether or not you should use Kegel exercisers depends on your personal health conditions, so you should speak with your physician about whether they are right for you.

Kegel Exercisers For Atrophy

To learn more about the importance of Kegel muscles and how to keep them strong and healthy, please see our guides:

Clitoral Vibrators & Air Pulse Stimulators

Stimulating the clitoris will bring the most sexual stimulation to the vagina. As the head of the clitoris is stimulated, the entire clitoral structure becomes filled with blood and engorges.

G-spot & Clitoris Diagram

The clitoral legs wrap around the inside of the vagina and provides stimulation and increased blood flow to the vagina. Using a clitoral stimulator such as a vibrator, air pulse, or clitoral suction stimulator is one of the most efficient ways to provide stimulation.

Clitoral Stimulators For Atrophy

For more helpful information, please see our guides: 

Sex Position Pillows

Sex position pillows can be quite helpful with vaginal atrophy or surgical adhesions as they provide comfort in various sexual positions. To learn more about them, please see our guide: Using Sex Pillows To Enhance Sex.

Sex Toy Cleaners

You should always use non-porous sex toys vaginally, especially if you have pain and/or atrophy. By using non-porous sex toys, you will not need a sex toy cleaner, but if you want to be especially diligent in cleaning your products, they may be a good option. To learn more, please see our helpful guides:

A Pessary Device

In cases where pelvic organ prolapse (POP) is causing pain, a removable vaginal pessary (an insertable doughnut-shaped ring) can be inserted into the vagina to hold the bulging vaginal tissues in place. For more information about vaginal prolapse, please see our guide: Vaginal Prolapse Help.

Pessary Devices For Vaginal Prolapse


One of the most important things you can do for yourself in addition to exercise is to nurture yourself with proper nutrition. Your body, including your vagina, will be in much better health when it has a healthy diet fueling it. We have put together an excellent nutritional guide for health and invite you to explore it for helpful information: Nutrition Guide for Good Sex & Health.

In Closing

Vaginal atrophy can feel emotionally, mentally, and physically challenging. It can impact your self-esteem and relationship with a significant other. We specialize in sexual health and wellness and not only provide body-safe sexual products but helpful sex educational guides to empower you. If you or a physician you are working with have any questions, please don't hesitate to contact us as we are happy to help.

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