Menopause & Vaginal health
What happens to Vaginal health in Menopause?
During perimenopause and menopause, declining oestrogen levels can significantly impact vaginal and urinary health.
Oestrogen plays a key role in maintaining the vaginal microbiome, tissue integrity, and natural lubrication.
As levels decrease, this can lead to thinning of vaginal tissues, reduced Lactobacillus bacteria, and increased susceptibility to irritation and infection.
These changes are often referred to as genitourinary syndrome of menopause (GSM).
Common Symptoms
Symptoms may include: vaginal dryness, irritation, burning, discomfort during sex, and changes in vaginal discharge.
Some women may also experience recurrent urinary tract infections, urinary urgency, or discomfort when urinating.
Symptoms can develop gradually and may persist or worsen over time without appropriate support.
Why Symptoms occur ?
Reduced oestrogen levels can lead to changes in the vaginal microbiome, including a decline in protective Lactobacillus bacteria.
This creates an environment where irritation, infection, and imbalance are more likely to occur.
Vaginal tissues may also become thinner, less elastic, and more sensitive, contributing to ongoing discomfort.
These changes can increase the risk of recurrent thrush, bacterial vaginosis, and UTIs.
Microbiome & Hormonal changes
The vaginal microbiome is closely influenced by hormonal balance.
As oestrogen declines, the protective acidic environment of the vagina may be altered, allowing less beneficial bacteria to grow more easily.
This can contribute to persistent or recurrent symptoms, even when standard treatments are used.
Understanding this relationship is key to supporting long-term vaginal and urinary health.
Conventional Treatment
Conventional treatment may include vaginal moisturisers, lubricants, and local oestrogen therapy.
These approaches can be effective in improving symptoms and supporting vaginal tissue health.
However, they may not always address the broader factors contributing to ongoing imbalance or recurrence.
Integrative approach to Menopausal Vaginal health
In my clinical practice, menopausal symptoms are assessed from both a hormonal and microbiome perspective.
1. Comprehensive Clinical History - A detailed consultation explores symptoms, hormonal stage, medical history, and contributing lifestyle factors.
2. Vaginal Microbiome Testing - Where appropriate, advanced testing may be recommended to assess Lactobacillus levels, bacterial balance, Candida species, and patterns of vaginal dysbiosis. This helps guide more targeted and individualised care, particularly in women with persistent or recurrent symptoms.
3. Targeted Treatment - Treatment may include appropriate therapies such as local oestrogen, antifungal or antibacterial treatment where indicated, alongside strategies to address contributing factors and restore balance.
4. Microbiome Support - Once symptoms are stabilised, supporting the vaginal ecosystem becomes important. This may include targeted probiotic therapy, microbiome support strategies, and lifestyle approaches that promote a healthy vaginal environment.
The goal is to restore Lactobacillus dominance, improve tissue health, and reduce recurrence of symptoms over time.
When to seek my Care
If you experience: persistent vaginal dryness, discomfort, recurrent infections, or urinary symptoms during perimenopause or menopause, further assessment may be helpful.
A personalised approach can help identify contributing factors and support long-term symptom relief and improved quality of life.
For enquiries feel free to get in touch.
We provide confidential, integrative women’s health care via telehealth — accessible, private, and designed for long-term results.
Email us: [email protected]
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