Oestrogen levels decline after the menopause and this can cause changes in our vaginal health, with around 1 in 2 women experiencing vaginal dryness, itching or uncomfortable sex, also known as vaginal atrophy (VA).
VA is a condition in which the decrease in oestrogen after the menopause causes thinning of the tissues in and around the vagina, decreased flexibility and elasticity of the vagina and a decrease in the mucus production that provides a moist vaginal environment (figure 1).
Lower oestrogen levels associated with the menopause also lead to a higher pH in the vagina, resulting in overgrowth of some bacterial species. This can make postmenopausal women more susceptible to vaginal and urinary tract infections.
VA affects around 50% of postmenopausal women but many are unaware of the cause, or that treatment is available.
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