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Vaginal Atrophy 101

Experiencing vaginal dryness, incontinence, painful sex, or frequent UTIs? Most women are not aware that these symptoms are attributable to menopause - and are highly treatable.
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What is vaginal atrophy?

Vaginal atrophy is a condition that happens when the vaginal skin becomes thin and dry due to lack of estrogen. Vaginal atrophy is a component of the genitourinary syndrome of menopause.

The genitourinary syndrome of menopause (GSM) is a term that is meant to replace the term "vaginal atrophy". GSM describes the symptoms and signs of lack of estrogen in the vagina, labia, urethra, and bladder.


The cause of GSM is pretty simple. GSM happens as estrogen levels decline, and this usually starts in your 30s and 40s during perimenopause and gets worse with time. Since GSM is tied to menopause (and all women go through menopause), 100% of women need to know that they are not alone in their symptoms.

Symptoms and signs

You might experience some or all of the symptoms and signs of GSM.

  • Genital symptoms include: Dryness, burning, and irritation
  • Urinary symptoms include: Pain when peeing, urgency to pee, getting up at night to pee
  • Sexual symptoms include: Pain and dryness
  • Physical changes and signs: These can vary

Initially you might notice irritation of the vulva, lack of vaginal lubrication, burning, pain when peeing, pain with sex, and vaginal discharge.

If you examine your body, you might see labial atrophy, vaginal dryness, shortening of the vaginal canal, clitoral atrophy, an elevated vaginal pH, and loss of volume in the vulva.

Signs of severe GSM include vaginal skin that's fragile, bleeding, or forming red bumps or tears. The urethra can become exposed and this can be very painful.

GSM can increase the likelihood of frequent UTIs, bleeding with or after sex, and loss of libido.


GSM will not magically go away on its own. So if vaginal dryness, painful sex, frequent UTIs, or incontinence is not something you want to just deal with, know that you have options.

One of the most effective treatments is low-dose topical vaginal estrogen, which you can get in different forms - including estradiol vaginal cream and estradiol vaginal suppositories. Topical vaginal estrogen is not absorbed significantly throughout the body, so it can be a great option if you do not want or cannot take oral estrogen. It's a prescription medication, so you can't get vaginal estrogen over the counter, but we offer it here at Interlude through an online consult with prescription included.

Alternatives to low-dose vaginal estrogen

You can apply a good vaginal moisturizer on a regular basis and use a lubricant during intimacy, but this will only help with vaginal symptoms. Home remedies might help relieve some symptoms, but probably won't help in the long term.

You can use hormone-based treatments like oral estrogen or patch estrogen to treat GSM. However, these therapies aren't for everyone.

If you have pain when peeing or vaginal odor, you might think it's a UTI or bacterial vaginosis. If you're in perimenopause or menopause, antibiotics alone will probably not solve the problem. Vaginal estradiol cream, rather than antibiotics, can probably address the root cause and prevent repeat infection.

Getting the help you need

If you're looking for an easy and convenient way to treat GSM or vaginal atrophy from home, our board-certified doctors offer estradiol vaginal cream and estradiol vaginal suppositories with an easy telehealth consult.

Step 1

Choose your vaginal atrophy treatment

We offer estradiol vaginal cream or estradiol vaginal suppositories.
Step 2

Complete your health profile

After you complete checkout, you'll answer questions about your symptoms and health history.
Step 3

Reviewed within hours

Within hours, a board-certified physician will review your info and prescribe if appropriate. You can message them at any time from your Interlude account.
Step 4

Free delivery

Your shipment arrives at your door in 3-5 days.
Here when you need us

Free to cancel or get support

If you have any medical questions, it's free to message your doctor. And, we'll text you before every refill in case you need to cancel or postpone. No surprises here.

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