Vaginal symptoms in the menopause: cause, impact and treatment combination options

02 February 2024
Volume 35 · Issue 2


Vaginal changes during the menopause may cause women to present to their practice nurse. Pearl Clark Brown explains diagnosis and management.

Vaginal symptoms which appear around the time of the menopause often occur as a result of declining levels of oestrogen within the epithelial tissues. Vaginal dryness, painful sex, itching, inflammation, burning and soreness are common symptoms around this time. It is thought that up to 80% of women will develop vaginal symptoms in varying degrees once menopausal. The effect that this can have on theindividual can be far reaching, impacting on normal day to day tasks such as sitting, the ability to have sex and being able to take part in exercise. Treatment options include vaginal oestrogen, non hormonal vaginal moisturisers, use of personal lubricants and emollients for washing with. Optimal relief can involve a combined treatment approach used regularly alongside a sliding scale of product use according to the severity of symptoms in response to stressors such as sex, stress or situations known to exacerbate symptoms.

The arrival of new, uncomfortable and unexpected vaginal symptoms around the time of the menopause can feel like the last straw when a patient might already be struggling to deal with a myriad of physical, mental and emotional changes at the same time.

On average, some people will begin to notice certain physical or vasomotor symptoms from the age of 45 and upwards, but some can develop more subtle symptoms before this, not always associating it with the menopause. (Peycheva 2022) Some symptoms can initially appear out of the blue and then disappear before returning later.

Period irregularity, new aches and pains, changes to mood, dwindling libido and reduced cognitive ability are common complaints at this time with varying degrees of severity and impact on daily life (BMS August, 2023).

Fluctuating and declining levels of oestrogen during the perimenopause can leave some people unable to fulfil usual work duties on some days, feeling low, lacking in confidence or motivation and exhausted and exasperated by day flushes and night sweats from one week to the next.

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