Vaginal atrophy refers to inflammation, dryness, and thinning of the vaginal walls. Natural remedies include using lubricants, staying sexually active, exercising, and avoiding smoking.

This article examines some helpful natural remedies, lifestyle changes, and medical treatments that can reduce symptoms and enhance the quality of life for people with vaginal atrophy.

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Where applicable, the following lifestyle measures could help relieve the symptoms of vaginal atrophy:

  • Giving up smoking: Smoking decreases estrogen levels and increases the risk of developing vaginal atrophy and other conditions, such as osteoporosis.
  • Being sexually active: Sexual activity increases the flow of blood to the genitals, which helps keep them healthy.
  • Avoiding perfumed products: This includes powders, soaps, and deodorants. It is important to note that certain perfumed lubricants and spermicides can also irritate the vagina and cause dryness.
  • Getting regular exercise: Frequent exercise and physical activity help with hormone balance.
  • Keeping well-hydrated: This can help maintain moisture levels in the body.

Diet and vaginal atrophy

At present, scientific research provides little evidence to support any claims that dietary changes can help with vaginal atrophy.

People with vaginal atrophy should discuss any herbal supplements or dietary changes with their doctor before making any long-term lifestyle changes to manage a condition.

Natural lubricants

Some natural lubricants might help soothe and lubricate the genital area.

These include:

Complementary treatments

Probiotics are bacteria that have a positive effect on the body. Research suggests that probiotics combined with estrogen may improve the symptoms of vaginal atrophy.

A 2019 study found that combining oral phytoestrogen with probiotics resulted in significant improvements in vaginal atrophy symptoms, particularly vaginal dryness and pain during intercourse.

Further research is necessary to confirm the benefits of probiotics.

Vitamin D

Various studies have suggested that vitamin D deficiency may contribute to vaginal atrophy and other menopausal symptoms. Supplementing with vitamin D may help.

A 2023 study looked at the effects of using a vaginal cream containing vitamin D and vitamin E. After 4 weeks of use, participants reported improvements in vaginal dryness, itching, and burning.

An older study gave participants vitamin D vaginal suppositories over 8 weeks and found significant improvements in different types of vaginal cells and a decrease in vaginal pH. A higher vaginal pH level, meaning a less acidic environment, is often associated with vaginal atrophy.

Supplementing with oral vitamin D does not seem to be associated with improvements in vaginal pH.

More research is necessary to understand the effect of vitamin D supplementation on vaginal atrophy.

As well as natural remedies and lifestyle changes, there are several treatments for vaginal atrophy.

Many of the following options are available over the counter:

  • Water-based, glycerine-free lubricants: These help reduce discomfort during sex.
  • Water-based vaginal moisturizers: These have longer-lasting effects than lubricants.
  • Topical estrogen cream: A person can apply this directly to the vagina to relieve symptoms quickly and effectively. It also reduces the exposure of the bloodstream to estrogen.
  • Oral estrogen: This has effects throughout the body, so it can be helpful for people experiencing several menopausal symptoms.
  • Estrogen-releasing ring: This remains in the vagina and releases estrogen steadily.
  • Systemic estrogen therapy: This is available as a skin patch, an implant under the skin, tablets, or a topical gel.

Systemic estrogen therapy may have the following side effects:

There might also be a slightly increased risk of developing blood clots and breast cancer with this type of treatment.

However, the benefits usually outweigh the risks.

The effect of previous breast cancer on treatment options

Anyone with a history of breast cancer should consult their doctor regarding potential treatment.

Estrogen can be harmful to people with a history of breast cancer. If the cancer is hormone-sensitive, estrogen might increase the risk of it returning. For this reason, a doctor will not usually recommend systemic estrogen therapy to someone who has previously had breast cancer.

The following are the most suitable choices for people with vaginal atrophy who have had breast cancer:

  • nonhormonal treatments, such as moisturizers and lubricants
  • low dose vaginal estrogen if nonhormonal treatments have not relieved the symptoms

Vaginal atrophy can occur at any age, although one main cause is reduced estrogen production in the ovaries during menopause.

Estrogen is the hormone responsible for female sexual development and menstrual regularity. It helps promote bone and skin health and supports other tissues in the body. Estrogen can also influence brain activity and mood.

People experiencing perimenopause, alongside other medical conditions that reduce the levels of estrogen in the body, can also develop vaginal atrophy.

The following factors can reduce estrogen levels:

  • certain types of birth control, including the contraceptive injection and the combined pill
  • a lack of arousal before intercourse leading to nonproduction of natural lubricant
  • nursing or childbirth
  • hormonal cancer treatments, chemotherapy, and radiotherapy to the pelvic area
  • diabetes
  • Sjögren disease, in which the immune system attacks fluid-producing glands in the body

The symptoms of vaginal atrophy can vary, and a person will not necessarily experience all of them at the same time.

These include:

Vaginal atrophy is a highly personal condition, and people might feel embarrassed to discuss symptoms with a doctor.

However, this hesitation can prevent an individual from seeking the treatment they need. The condition is very common, and treatment can yield good results.

Anyone experiencing the following should seek medical attention:

  • Vaginal symptoms are severe and interfere with daily function.
  • Sexual intercourse is painful, and vaginal lubricants do not provide relief.
  • There is bleeding, burning, or discharge from the vagina.
  • Accompanying symptoms occur, such as night sweats and hot flashes.
What is the best way to treat vaginal atrophy?

Vaginal atrophy is easier to prevent than treat.

Being sexually active, even if you are alone, helps maintain muscle tone and high quality blood flow to the area. Allow enough time for foreplay to make sure that the vaginal walls are lubricated before penetration.

Use a water-based lubricant or vaginal moisturizer to reduce discomfort and skin irritation. Oil-based products can break down condoms.

If you still experience symptoms, see your doctor. There are estrogen creams that work at a local level, with very little getting into your bloodstream. Your doctor might consider vaginal estrogen tablets or a vaginal estrogen ring. This ring releases estrogen in the area and into your blood and needs to be replaced every few months.

And if these measures still do not relieve symptoms, your doctor will consider if you are a candidate for oral hormone tablets. Previous medical conditions, such as cancer, may disqualify a woman from taking hormones orally.

Vaginal issues can be embarrassing to discuss with a healthcare provider, but help is available.

— Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT

Natural treatments for vaginal atrophy include lifestyle measures, such as quitting smoking, being sexually active, and staying hydrated. Vaginal lubricants and moisturizers may also ease uncomfortable symptoms.

Doctors may recommend hormone therapy to replace depleted estrogen, as it plays an important role in vaginal health.