Fact Sheet

Vaginal Atrophy

  • Editors
  • JoAnn V. Pinkerton, MD
    Richard J. Santen, MD

What is vaginal atrophy?

Vaginal atrophy is a condition in which the lining of the vagina becomes thinner and drier.  This condition can lead to vaginal and urinary tract problems.

Did you know?

Many women are unaware that they can get treatment for vaginal atrophy.  Prompt treatment can keep problems from getting worse.

What are the symptoms of vaginal atrophy?

You may have no symptoms at all.  Or you may have

Vaginal atrophy also can increase your risk of vaginal infections and urinary tract infections.

What causes vaginal atrophy?

Vaginal atrophy occurs when your body lacks estrogen.  Estrogen is a female sex hormone that influences sex traits, growth, and reproduction.  Levels of estrogen can decrease

Your risk for vaginal atrophy also goes up if you smoke or if you’ve never given birth vaginally.

How is vaginal atrophy diagnosed?

Your doctor will ask about your symptoms and do a pelvic exam to look at the appearance of your vagina.  Your doctor also may analyze a urine sample and/or perform a Pap test.

What are the treatment options for vaginal atrophy?

Both non-prescription and prescription options are available.  You and your doctor will talk about the best option for you.

Non-Prescription Treatments

Some women find that non-prescription treatments work well, especially for mild symptoms.  Non-prescription treatments are hormone-free and have few side effects.

Types of Non-Prescription Vaginal Treatments

How to Use


Apply to the vagina two or three times a week.


(water-based or silicone-based)

Apply to the vagina before intercourse.

Lubricants (oil-based), such as olive oil, vegetable oil, or other products

Use at the opening of the vagina but not inside; do not use with condoms or diaphragms.

Women who have pain during intercourse because of overactive pelvic muscles can learn how to relax those muscles by using a device called a vaginal dilator or with physical therapy.  Having regular sexual activity, with or without intercourse, also can help relieve symptoms, as does allowing enough time to become aroused.

Prescription Medicines

If you are having moderate or severe symptoms, you may need prescription forms of estrogen.  Two types of estrogen are available:  topical and systemic.


Types of Topical Estrogen Treatments

How To Use


Insert an applicator filled with cream into the vagina at bedtime.  Or, using a fingertip, apply a small amount of cream to the opening of the vagina.  Ask your doctor how often to use it.


Use a disposable applicator to insert an estrogen tablet into the vagina.


Insert an estrogen-releasing flexible ring into the vagina every 3 months.  Or your doctor can insert it.

If you’ve had breast cancer, talk with your doctor about what treatment is best for you.  Limiting or avoiding estrogen can help prevent a return of breast cancer. 

What should you do if you have symptoms of vaginal atrophy?

See your doctor.  Your doctor can find the cause of your symptoms and suggest options to help you feel better. 

Questions to ask your doctor

  • Do I have vaginal atrophy?
  • Will treatment relieve my symptoms?
  • What are my options for treatment?
  • What are the risks and benefits of each treatment option?
  • How long will I need treatment?
  • Should I see an endocrinologist?


Find-an-Endocrinologist: or call 1-800-HORMONE (1-800-467-6663)

Hormone Health Network information about menopause and women’s health:

Mayo Clinic:

MedlinePlus (National Institutes of Health): Go to and search for vaginal dryness