Vaginal atrophy affects around 70–80% of women after menopause, yet only around 10% seek medical help.
Many women assume symptoms such as vaginal dryness, discomfort, or pain during sex are simply part of ageing and that nothing can be done. Others feel embarrassed or uncomfortable raising the issue with a healthcare professional.
However, vaginal atrophy (also known as genitourinary syndrome of menopause, or GSM) is something doctors treat every day. There is no taboo in a medical setting, and effective support and treatments are available.
Vaginal Atrophy: What It Is, Why It Happens, and What Can Help
Many women notice changes in their vaginal health during and after menopause, but feel unsure about what’s “normal” or whether help is available. In this conversation, Catriona speaks with Dr Jackie Radley, a GP and menopause expert, to explore vaginal atrophy, a common but often unspoken condition.
The discussion focuses on understanding symptoms, reducing worry, and explaining the effective treatments that are available.
Top 5 highlights from the conversation
1. Vaginal atrophy is very common and very treatable
Jackie explains that vaginal atrophy affects a large number of women during and after menopause. Despite how common it is, many women suffer in silence, not realising that effective treatments exist and are widely recommended.
2. Symptoms can be subtle at first
The condition doesn’t always start with pain. Early signs can include dryness, irritation, soreness, or discomfort during sex, symptoms that are sometimes mistaken for infections or simply “getting older”.
3. It’s caused by low oestrogen, not poor hygiene
A key message from Jackie is reassurance: vaginal atrophy is a hormonal change, not something a woman has caused. Falling oestrogen levels affect the vaginal tissue, making it thinner, drier, and less elastic.
4. Local oestrogen is safe for most women
One of the most important points discussed is treatment. Jackie explains that local (vaginal) oestrogen is low-dose, works directly where it’s needed, and is considered safe for the vast majority of women, including many who cannot take systemic HRT.
5. Talking to a GP is the first step and women should feel confident doing so
Jackie encourages women to speak openly with their GP. Vaginal atrophy is a recognised medical condition, and support is part of routine menopause care. No one should feel embarrassed about asking for help.
Understanding vaginal atrophy
Vaginal atrophy, also known as genitourinary syndrome of menopause (GSM), happens when oestrogen levels fall most commonly during menopause.
Key facts:
It affects the vagina and sometimes the bladder
Vaginal tissue becomes thinner, drier, and less flexible
Symptoms often worsen over time if untreated
It does not usually improve on its own
Common symptoms include:
Vaginal dryness or soreness
Pain or discomfort during sex
Burning or itching
Recurrent urinary infections
A feeling of tightness or irritation
The good news is that vaginal atrophy is very treatable, and early treatment can significantly improve comfort and quality of life.
About the expert
Dr Jacqueline Radley is a GP and British Menopause Society Accredited Menopause Specialist
Dr Jacqueline Radley is the founder of The Birmingham Menopause Clinic. She provides personalised care across perimenopause, menopause and postmenopause, integrating hormonal and non-hormonal therapies to support long-term health.
Her interests include complex menopause, neurodiversity, testosterone therapy and the mental health impact of hormonal change. With postgraduate training in lifestyle medicine and medical education, she blends clinical expertise with a holistic approach, helping people understand their symptoms and make informed choices.
Jackie is committed to breaking taboos around vaginal atrophy, libido and mood, and to delivering clear information and truly individualised care.
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