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The inevitable decrease in oestrogen during the whole menopause process can often cause issues with vaginal dryness. It doesn’t just stop at dryness though. Some women also experience pain, itching, burning and painful intercourse. Bad times. If you’ve had a dose of thrush you know the sitch.

The technical/medical term for this is genito-urinary syndrome of the menopause (GSM). Unfortunately, unlike hot flushes and the fact that they improve over time, vaginal atrophy actually gets worse. This is why it shouldn’t be ignored and for your own comfort and sanity, you might need to address it.

What exactly happens?

There are lots of ways the lady garden area might be affected. Some of the more common ones are listed here:

  • vaginal tissues become a lot thinner, more dry and less elastic. This leads to less secretions and therefore, less lubrication
  • An increase in infections because the healthy pH changes
  • Uncomfortable when peeing
  • Increased urinary tract infections (UTI’s)
  • Tissues may bleed as they are quite fragile and susceptible to tearing
  • Painful sex
  • Narrowing of the vagina and involuntary tightening of the vaginal muscles


What can you do?

OK then. Yes, something can be done about it. There are a number of things that can help which include both hormonal and non-hormonal remedies.

Vaginal lubricants

There are loads of these available without a prescription. A lubricant will help reduce any pain or discomfort you have during sex. Try to stick with water soluble or silicone ones rather than those containing oil as the oil can irritate the tissues.

Pelvic floor exercises

These can help strengthen muscles and relax tight ones to increase comfort.


If you’re in the habit of using moisturiser on your face at night, why not get into the habit of moisturising your vagina too?? Yes there are moisturisers especially for your vagina! You can pick them up relatively inexpensively online or from larger pharmacies. You can get both internal ones with applicators and ones you can use on the outer area around the vulva too.

It’s not all about sex

If intercourse is painful, then just don’t do it. There’s loads of other “stuff” you can do that will bring pleasure and orgasm. Think about stuff like mutual masturbation, oral sex or massage as ways to still be intimate but without the pain and discomfort.

Do it often!

Believe it or not but regular stimulation of the vagina can help with blood flow and increasing secretions! You can do this with your partner/spouse or on your own with aids such as vibrators.


There are a couple of options for hormone therapy. If your only symptoms are vaginal dryness, pain etc or it’s quite significant, a good option is to use an oestrogen treatment directly for the vagina. These are available on prescription and you should discuss with your GP which one would be best for you. They come in a range of options such as creams, vaginal tablets and rings.

If you have a number of other symptoms too, you might find that oral or transdermal HRT will work best for you. Again, there are a number of options here and you should discuss with your GP which one is most suitable for you. If you want more info on HRT, I have written quite a comprehensive blog post here which you might find useful.

Let me know if you’ve had success with any of these treatments in the comments (only if you’re comfortable sharing obvs!).

Hi, I'm Kerry. I'm a menopause coach for women who want to take control of their menopause and do it their way.


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