Perimenopause and menopause

Dryness, irritation, urinary changes, and pain have options.

Lower estrogen can change vulvar and vaginal tissue, lubrication, elasticity, comfort, and urinary symptoms. These changes are common, but you do not have to simply endure them.

Check a current concern

An older adult discusses vaginal, urinary, and tissue changes with a clinician in a calm consultation room. — Original editorial illustration. Not clinical evidence or a diagnostic image.

What may change

Tissue can become thinner, drier, or more sensitive. Some people notice pain with penetration, burning, urinary urgency, or repeated urinary infections.

Symptoms can begin during perimenopause
Products that once felt fine may become irritating
Other infections and skin conditions can still occur

What may help

Options depend on symptoms, medical history, preferences, and whether symptoms are mainly with sex or present day to day.

Lubricants reduce friction during sexual activity
Vaginal moisturizers are used on a schedule
Prescription local or systemic treatments may be options after a clinical discussion

What should be checked

Bleeding after menopause is not something to self-diagnose. New lesions, persistent pain, or urinary symptoms also deserve evaluation.

Arrange evaluation for any postmenopausal bleeding
Seek prompt care for severe pain, significant bleeding, or fever
Ask about vulvar skin examination when external symptoms persist

Sources for this pathway

ACOGThe Menopause Years ACOGDisorders of the Vulva ACOGVulvovaginal Health