Vulvovaginal Atrophy (VVA)

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When changes in vaginal tissue impact intimate well-being

Vulvovaginal atrophy is common among menopausal women1. It affects vaginal health and can significantly impact quality of life5.

The condition and its symptoms

What is Vulvovaginal Atrophy?

Vulvovaginal Atrophy is a condition that affects the female genital area. It is primarily associated with reduced oestrogen levels, most commonly during menopause, but may also occur in other hypo-oestrogenic states1.
Oestrogens are hormones that play several roles in the female body. They help maintain proper vaginal pH1, regulate vaginal blood flow1, support lubrication3, and keep vaginal tissue healthy and flexible3.
When oestrogen levels drop, symptoms like vaginal dryness and discomfort can develop1. Without appropriate management, symptoms may persist and can impact quality of life5.

Vaginal discomfort and pain2

Less elastic vaginal tissue

Less elastic vaginal tissue4

Vaginal dryness

Vaginal dryness3

Redness of the vaginal lining

Thinning and inflamed vaginal lining4

A consequence of menopause

Vulvovaginal atrophy, now commonly recognised as part of Genitourinary Syndrome of Menopause (GSM), is associated with reduced oestrogen levels, most often during menopause. Lower oestrogen can lead to changes in vaginal tissue, causing symptoms such as dryness, irritation, discomfort, and reduced elasticity, which may affect quality of life. Women experiencing symptoms should seek advice from a healthcare professional5.

Urinary symptoms3

  • Needing to urinate often
  • Leaking urine
  • Burning when urinating
  • Recurrent urinary tract infections
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Sexual symptoms3

  • Pain or discomfort during sexual intercourse
  • Difficulties with sexual function or satisfaction
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Who is affected by Vulvovaginal Atrophy

Vulvovaginal atrophy can affect women in low-oestrogen states and is most common during menopause1.

 

Studies show that symptoms of vulvovaginal atrophy are common among postmenopausal women5.

 

Symptoms may also occur temporarily during periods of reduced oestrogen levels.

Some situations where oestrogen levels decrease temporarily:

After childbirth

During breastfeeding

While undergoing certain breast cancer treatments

When taking specific medications that affect hormone levels

How Vulvovaginal Atrophy develops

The decrease in oestrogen levels during menopause leads to both structural and functional changes in vaginal tissues.

Cause

Changes in tissue structure and pH

Reduced oestrogen levels are associated with changes in tissue structure, including alterations in vaginal pH. Changes in vaginal pH may alter the vaginal microbiota and increase susceptibility to irritation or infection1.

Cause

Physical changes to the vagina

The vagina undergoes physical changes as well. The vaginal canal may become narrower and shorter, and the vaginal opening may reduce in size. These changes can make intercourse difficult or painful3.

Data about Vulvovaginal atrophy and Genitourinary syndrome of menopause

Vulvovaginal atrophy can have a significant impact on women’s intimate lives and overall well-being5.

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65%

Report less sexual satisfaction2

The Revive (Real women’s views of treatment options for menopausal vaginal changes) survey of 3046 postmenopausal women with GSM.

62%

Say it affects their ability to be intimate2

The Revive (Real women’s views of treatment options for menopausal vaginal changes) survey of 3046 postmenopausal women with GSM showed VVA has negative impact on the ability to be intimate 62%.

55%

Say their relationship has suffered2

The Revive (Real women’s views of treatment options for menopausal vaginal changes) survey of 3046 postmenopausal women with GSM.

Diagnosing the disease

Professional medical evaluation is essential for diagnosing vaginal atrophy.

To diagnose the condition, the doctor will ask about your symptoms, their duration, and any related factors. Additional tests may be requested to rule out other conditions with similar manifestations.

 

A pelvic examination may also be performed to look for signs of atrophy, such as thinning of the vaginal epithelium, loss of rugal folds, and changes in mucosal colouration.

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The art of feeling

Comprehensive care for intimate well-being

At IBSA, we approach uro-gynecological conditions with the sensitivity and expertise they deserve. Our solutions are grounded in rigorous research, designed for patient comfort, and supported by comprehensive education.

 

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References

  • 1 / Mac Bride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc. 2010 Jan;85(1):87-94. doi: 10.4065/mcp.2009.0413.
  • 2 / Nasreen SZA, et al. American Journal of Internal Medicine. 2019;7(6):154-62.
  • 3 / Benini V, et al. Medicina (Kaunas). 2022;58(6):770
  • 4 / Christmas M, et al. Clin Obstet Gynecol. 2024;67(1):101-14.
  • 5 / Palacios S, Nappi RE, Bruyniks N, Particco M, Panay N; EVES Study Investigators. The European Vulvovaginal Epidemiological Survey (EVES): prevalence, symptoms and impact of vulvovaginal atrophy of menopause. Climacteric. 2018 Jun;21(3):286-291. doi: 10.1080/13697137.2018.1446930. Epub 2018 Mar 19.

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