Symptoms of Vaginal Atrophy (& Natural Ways to Protect Vaginal Health)

I’m a huge advocate of giving women the information they need to improve their own health (which is one reason I love the menstrual cup so much!). When I received several questions in a row about vaginal atrophy (a topic I didn’t know anything about), I knew I needed to call in an expert!

I called my brilliant friend Dr. Anna Cabeca, a triple board-certified OB/GYN, formulator of a natural vaginal atrophy remedy, and expert in all things women’s health. She helped compile much of the research for this post and she explained what is really going on with vaginal atrophy and which natural remedies are available.

The good news?

There are many ways to remedy and even reverse vaginal atrophy!

What Is Vaginal Atrophy?

In short, vaginal atrophy is the thinning, drying, and inflammation of the vaginal walls. It’s also known as:

• atrophic vaginitis
• vulvovaginal atrophy
• genitourinary syndrome

This change in the vagina is caused by a reduction in estrogen levels (but can be related to the reduction of other sex hormones). It is typically associated with menopause but can happen at other times when hormones are fluctuating, like after childbirth. It can also occur when hormones are out of balance for other reasons.

Symptoms of Vaginal Atrophy

The main symptom of vaginal atrophy that often bothers women is vaginal dryness. Other symptoms can include the following:

• vaginal dryness and discomfort
• painful intercourse
• shortening and tightening of the vaginal canal
• lowered libido and fewer orgasms
• urinary problems like leakage when coughing, laughing, or sneezing
• more frequent bladder and vaginal infections
• vulvar or vaginal pain
• vaginal discharge
• urinary tract infections
• loss of pelvic muscle strength (which can lead to pelvic prolapse, inability to eliminate, or need for surgery)

While we sometimes act like our health takes care of itself “down there,” reading this list of uncomfortable or even painful symptoms shows that is anything but true!

Many women believe that incontinence after motherhood is inevitable. But it doesn’t have to be (and can even be reversed).

Causes of Vaginal Atrophy

The main cause of atrophy of the vagina is a lack of estrogen.

Estrogen decline often happens more rapidly after menopause. But it can also happen at other times in life. Hormone production starts declining when a woman is in her 20s!

Add to that the toxic environments we live in and the lifestyle choices and chronic stress that can further throw off hormonal balance. It’s not a surprise that many women deal with vaginal atrophy.

You may be particularly at risk for low estrogen if you:

• are post-menopausal
• smoke (reduces blood flow)
• use birth control pills (read about natural alternatives here)
• receive hormonal treatments
• have certain autoimmune diseases

Estrogen decline is a normal part of getting older but vaginal atrophy doesn’t have to be. There are many natural remedies for vaginal atrophy that are simple and safe to use.

Natural Remedies for Vaginal Atrophy

While quite common, it isn’t inevitable (and you can even reverse it!). The key is to do things to support vaginal and pelvic health throughout life to avoid getting vaginal atrophy in the first place. If it becomes a reality anyway, these remedies and treatment options can help improve the situation. Many of these are non-hormonal treatments!

Change Your Diet

Diet is always the first step in building health. We truly are what we eat. But the specific healthy diet we follow (paleo, keto, WAPF) is a matter of personal choice and how it benefits us.

Some people do better on one diet versus another, but one universal truth seems to be that alkalizing diets are better than acidic diets. That makes sense when you take a look at alkalizing foods (vegetables and fruits) versus acidic foods (meat, dairy, grains, processed foods, etc).

Dr. Anna Cabeca recommends a keto-green™ (or to be specific a keto-alkaline®) diet, which is essentially a keto diet done right. She says that this kind of alkalizing diet helps support a healthy gastrointestinal tract and vaginal pH.

Balance Hormones

When vaginal atrophy happens years before menopause, hormone imbalance may be the most likely cause. Hormones control so many functions in the body. From growth in children and reproduction in adults to weight, mood, bowel health, and vaginal health, hormones drive it all.

The endocrine glands in the body (as well as the ovaries in women and the testicles in men) produce these important hormones. When we don’t get enough of the building blocks for hormones the body tries to produce hormones with what is available. This can result in mutant hormones. Thankfully, there are some simple natural ways to get hormones back into balance.

• Eat enough healthy fats – Those hormones can’t be produced properly without the right building blocks, and healthy fats are key! Coconut oil, pastured butter and ghee, and animal fats from healthy animals are excellent building blocks.
• Avoid chemicals – Chemicals in man-made products like mattresses, plastics, and other products can be endocrine disruptors. That means these chemicals mimic natural hormones and keep the body from producing them naturally. There are better mattresses out there, as well as easy ways to reduce plastic in the home. It won’t happen overnight, but it’s worth making changes step by step.
• Get enough sleep and exercise – The body does a lot while we’re sleeping. It removes toxins, produces hormones, and recharges the mind and body. Making sleep a priority will do wonders for your hormones! Exercise is also important and can even trigger hormone production. A sleep and movement tracker may help awareness and healthy habits in both areas.
• Support the gut – Gut health is so important that any of the other things we can do to improve hormone balance may not work without addressing the gut health issue first. Looking at your poop (yes, really) may give some important clues as to how your gut health is doing.
• Address leptin – The master hormone leptin controls all hormone function. If it’s not in balance, the others won’t be either. Here’s how to know if you might have a problem with leptin resistance and what to do (hint: food cravings may be a sign).

Try Vulvar DHEA

Many women are prescribed estrogen in the form of estrogen cream or systemic estrogen therapy for vaginal atrophy symptoms. It works well for improving the thickness and elasticity of the vaginal lining. The problem? It doesn’t affect the deeper tissue or supporting muscles.

Additionally, there are negative side effects associated with systemic estrogen therapy. These include:

• breast tenderness
• stomach pain
• vaginal bleeding
• headaches
• nausea or indigestion

According to Dr. Cabeca, research also doesn’t show that low-dose vaginal estrogen has any beneficial effect on incontinence.

But vaginal DHEA (an androgen hormone like testosterone) improves the musculature of all three layers. A 2016 study published in Menopause found that DHEA cream penetrates deeper to promote faster healing, while vaginal estrogen improves only the top layer. DHEA is an important hormone for libido and also affects skin, bones, and muscles.

You can find out more about this topic and grab a free trial of Dr. Anna’s Julva cream with DHEA at this link.

Bioidentical Progesterone

Progesterone is an important hormone for women when it comes to pregnancy and menstrual cycles. At the beginning of each menstrual cycle, progesterone is low. After ovulation, progesterone rises until the period occurs. Women who don’t experience this rise in progesterone can experience symptoms like vaginal atrophy and also depression. Dr. Cabeca explains that using progesterone from ovulation through the period can help ease these symptoms.

One caution: Make sure to stick with bio-identical progesterone. Progestins (synthetic progesterone) has been shown to react differently in the body than natural or bioidentical progesterone. Some research even points to a link between progestin and breast cancer. This is the cream I would use if supplementing progesterone since I know it has Dr. Anna’s seal of approval.

Use Natural Lubricants

While natural lubricants and vaginal moisturizers aren’t going to fix the underlying problem, they can be helpful to make sexual activity more enjoyable for women suffering from vaginal atrophy.

Some essential oils have been found to help moisturize the vaginal canal. Dr. Anna Cabeca recommends Salvia sclarea, Roman chamomile, Cape chamomile, rose, frankincense, lavender, and sandalwood. Always get essential oils from a quality source and dilute before use by adding them to any of the below oils:

• olive oil
• coconut oil
• vitamin E oil

Important note: Oils are not safe to use with condoms (oil can cause condoms to fail). Aloe vera is a good natural lubricant that is oil-free (and more natural brands of personal lubricants like this one now make it easy to use).

Have Sex

Want a totally free and natural fix? It turns out regular sexual activity helps increase blood flow to the vagina, which can help improve symptoms! This is another good reason to optimize hormones that support a healthy sex drive.

Exercise the Pelvic Muscles

As Dr. Anna Cabeca says, the “hammock” of the pelvic muscles is so important for vaginal health as well as urinary and fecal control. Without strong pelvic floor muscles organs can prolapse (come out of the body).

You may want to try kegels to help with this (here’s how), but kegels are just one isolated way of strengthening the pelvic floor muscles. There are many other things we can incorporate into our day that help strengthen these muscles like:

• Get moving more – We’re meant to move around all day long, not sit in front of a computer (I’m guilty of this too). Incorporating more movement into the day can help strengthen those muscles.
• Squat – Squatting is great for keeping the pelvic floor strong and healthy.
• Hip movement – Moving the hips in circles activates all of the muscles in your core including the pelvic floor, hips, back, and abs. Dancing is a great natural way to do this.

Keep in mind that these exercises are most helpful when you use proper posture and support core strength.

Other Options to Improve Vaginal Health Naturally

The above are the core ways to support the body to remedy vaginal atrophy. After I hung up the phone with Dr. Anna, I also researched a couple of other topics of interest on this issue. There are all kinds of promising non-invasive options to help women with this delicate and important area of health. I’ve learned about most of these from doctors on my podcast, so check out the episodes mentioned below to get all of the details:

Soundwave Treatments

Evidence now shows that sound waves can help tissue regenerate and heal. Soundwave treatments use low-intensity sound waves to support the growth of new healthy vaginal tissue and more responsive nerve receptors. Benefits of soundwave therapy include:

• restoring sensation
• enhancing natural lubrication
• making it easier to achieve orgasm
• reversing the symptoms of urinary incontinence

Vanessa Gaudin, board-certified Family Nurse Practitioner and expert in women’s health and wellness at HealthGAINs explained in this podcast how soundwave treatment stimulates dormant stem cells that can enhance tissue growth and healing.

This procedure is more invasive and certainly more expensive than the treatments listed above.

Platelet-Rich Plasma (PRP)

Platelet-rich plasma sounds a little strange but it can also be a remedy for vaginal atrophy. In the same podcast episode Vanessa Gaudin explained:

PRP, platelet-rich plasma, is an autologous product derived from your own whole blood. And what’s done is that it’s processed through a centrifuge. And what that is, is separating the red blood cells from the platelets and the plasma. Once that’s completed, it actually is taken and placed back into your body, just the plasma, just the platelets. And with that being completed, you’re actually able to help promote the natural process of wound healing, soft tissue reconstruction.

Often used in joints and for other types of injuries, this method is new and quite pricey. But a 2017 study published in Journal of Menopausal Medicine found that PRP can be an effective treatment for relieving vaginal atrophy symptoms. Some people report great results but there can be side effects and it is often necessary to have the procedure more than once.

Dietary Phytoestrogens

Phytoestrogens are foods that mimic estrogen in the body. In healthy people, it’s not a good idea to load up on these kinds of foods as it can cause estrogen dominance in women (and testosterone imbalance in men). But in women who are experiencing low estrogen (and who know that’s the cause of their symptoms), phytoestrogens may be a short-term fix.

Phytoestrogenic foods include:

• soy (if you choose to eat soy, stick with traditionally fermented options)
• apples
• carrots
• zucchini
• pomegranates
• strawberries
• cranberries
• grapes
• black tea
• green tea
• hops
• flaxseed

If hormonal imbalance (especially in younger women) is the cause of vaginal atrophy, I would be cautious about eating too many phytoestrogens. If we eat things that mimic estrogen, our bodies may stop producing that hormone. That’s exactly what we don’t want in this situation. With this and all health choices, consult your healthcare provider for what’s right for you.

Supplements and Herbs

There are also some supplements that are beneficial for improving vaginal atrophy symptoms:

• Sea buckthorn oil – Sea buckthorn oil can improve moisture and elasticity in the vaginal-vulvar area. This helps relieve vaginal dryness and irritation. A 2014 Finnish study shows that sea buckthorn oil is beneficial in helping heal vaginal tissue and is a good alternative to vaginal estrogen.
• Vitamin D – Vitamin D plays many parts on overall health and may be helpful for vaginal atrophy too. One Iranian study found that vitamin D had a beneficial effect on menopausal women experiencing vaginal dryness. It helped lower vaginal pH and reduced dryness.
• Maca – Some research shows maca stimulated natural hormone production in postmenopausal women. This resulted in a reduction of symptoms. Dr. Anna has formulated a high-quality maca supplement to help support female hormone health. It’s an especially interesting remedy because it seems to treat the underlying cause of vaginal atrophy and not just the symptoms.

Prevention Is Key!

We don’t always like to talk about it, but bottom line, uncomfortable vaginal symptoms shouldn’t have to be a natural part of getting older or having children. I’m glad to know now that taking care of vaginal health from early on can help avoid unpleasant problems later. Natural remedies can even help reverse symptoms once they do appear. As always, consult with your doctor to find the right remedies for your situation.

Do you suffer from vaginal atrophy? What remedies have helped you?

This article was medically reviewed by Dr. Anna Cabecca, MD, OB/GYN and medical advisor for WellnessMama.com. As always, this is not personal medical advice and we recommend that you talk with your doctor.