Vaginal atrophy is the medical term that refers to the thinning of the wall of the vagina that occurs during the menopause (the time when menstrual periods have ceased) in women.

• Vaginal atrophy occurs due to falling estrogen levels.
• Vaginal atrophy may be associated with vaginal dryness, itching, irritation, and/or pain during sexual intercourse.
• Hormone therapy can be effective in treating vaginal atrophy and other menopausal symptoms, but hormone therapy carries its own risks.
• Local vaginal hormone creams or vaginal lubricants are alternatives to systemic hormone therapy.

Many postmenopausal women experience GSM. But few seek treatment. Women may be embarrassed to discuss their symptoms with their doctor and may resign themselves to living with these symptoms.

Make an appointment with your doctor if you have any unexplained vaginal spotting or bleeding, unusual discharge, burning, or soreness.

Also make an appointment to see your doctor if you experience Painful intercourse that's not resolved by using a vaginal moisturizer (K-Y Liquibeads, Replens, Sliquid, others) or water-based lubricant (Astroglide, K-Y Jelly, Sliquid, others).

Vaginal dryness 

Typically, the vaginal lining consists of healthy tissues that are several layers thick and naturally moist. A dry vaginal lining becomes thinner and loses natural moisture.

Genitourinary syndrome of menopause is caused by a decrease in estrogen production. Less estrogen makes your vaginal tissues thinner, drier, less elastic and more fragile.

A drop in estrogen levels may occur:

• After menopause
• During the years leading up to menopause (perimenopause)
• After surgical removal of both ovaries (surgical menopause)
• During breast-feeding
• While taking medications that can affect estrogen levels, such as some birth control pills
• After pelvic radiation therapy for cancer
• After chemotherapy for cancer
• As a side effect of breast cancer hormonal treatment

GSM signs and symptoms may begin to bother you during the years leading up to menopause, or they may not become a problem until several years into menopause. Although the condition is common, not all menopausal women experience GSM. Regular sexual activity, with or without a partner, can help you maintain healthy vaginal tissues.

Vaginal dryness and atrophy do not need to be treated unless they cause symptoms or discomfort. Women who experience symptoms have several treatment options.

Certain factors may contribute to GSM, such as:

• Smoking. Cigarette smoking affects your blood circulation, and may lessen the flow of blood and oxygen to the vagina and other nearby areas. Smoking also reduces the effects of naturally occurring estrogens in your body.
• No vaginal births. Researchers have observed that women who have never given birth vaginally are more likely to develop GSM symptoms than women who have had vaginal deliveries.
• No sexual activity. Sexual activity, with or without a partner, increases blood flow and makes your vaginal tissues more elastic.

There's no cure for vaginal dryness and vaginal atrophy, but there are treatments that can help you feel more comfortable.

• The good news is there are many effective treatments for vaginal dryness—some of which you may be able to do on your own at home. If these don't work for you, talk to your doctor about other options that might help.
• There are also many medications available for treating vaginal atrophy (a condition that comes about when estrogen levels drop). Some of these drugs are topical creams or suppositories; others are taken orally in pill form. These medications can help restore moisture and improve elasticity in the vagina. If these don't work for you, talk to your doctor about other options that might help.
• If you're in the early stages of menopause, you might be able to use hormone therapy to relieve your symptoms. This is a good option if you aren't ready for menopause yet but are having issues with vaginal dryness and atrophy.
• If you've already gone through menopause and want to prevent further damage from vaginal dryness, you can use a lubricant like KY Jelly or Astroglide. These products can help relieve dryness and make sex more comfortable during sexual activity.
• Furthermore, if you are diagnosed with vaginal atrophy, the next step is to try some lifestyle changes and over-the-counter remedies. Some things that can help include using a water-based lube during sex, showering after sex instead of wiping (this will help keep your vagina clean) and using condoms during intercourse (they help prevent friction).
• If these methods don't work, there are a few prescription medications that may be able to help.

Symptoms
Pain during sex,Painful urination,Discomfort while sitting or standing,Bleeding between periods,Painful intercourse (dyspareunia)
Conditions
Thinning, drying and inflammation of the vaginal walls that may occur when your body has less estrogen
Drugs
Vagifem,Estrace Vaginal Cream,Estring Transvaginal Ring,Osphena