You Can Manage “The Change”

Before it became okay to call menopause by its name, women called it “the change”—with good reason. The waist thickens, the hair thins, and sleep goes haywire. You may be wondering if there is anything that doesn’t change after menopause. There might be (your favorite food?)—but add your vagina to the long list of things that do.

Declining estrogen changes the vaginal lining, making it thinner and less elastic. The official term used to be vulvovaginal atrophy (VVA), and you may see articles using that term (or hear it from your health care provider). Now, more accurately, it’s called the genitourinary syndrome of menopause (GSM). Symptoms include

  • Vaginal dryness, irritation, or burning
  • Burning and/or urgency with urination
  • Urinary tract infections
  • Urinary incontinence
  • Discomfort and/or light bleeding after intercourse

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A new study by European Vulvovaginal Epidemiological Survey (EVES) points to just how prevalent this condition is. In the study of over 2,000 women between the ages of 45 and 75, a gynecological exam was done on each woman who reported one or more symptoms. In 90 percent of those women, GSM was confirmed.

Women often overlook GSM, either because they aren’t aware that the condition even exists, or because they think of each of their symptoms as individual problems, rather than collective evidence of something else.

But as the EVES study also showed, women with GSM also experienced a lower quality of life than those who didn’t have GSM. That’s unfortunate, because, although GSM is chronic, it’s also treatable with, for example, localized (vaginal) estrogen or non-estrogens that restore health to genital tissues.

Your doctor can help, but only if you let your doctor know about your symptoms. So take a deep breath and explain what’s been going on. Once you begin treatment and see that there are ways you can manage the change, rather than just letting it happen to you, you’ll feel a whole lot better.


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