Vulvar Health in Menopause
What Every Woman Needs to Know
Let’s get clinical (and candid): vulvar health is a cornerstone of quality of life during menopause, but it’s rarely discussed openly—even in most doctor’s offices. It is so stigmatized, that so many don’t even know what their own vulva’s look like. I encourage you as a woman, get a mirror and take a look. Get familiar. Get to know every freckle and fold. It’s especially important to do this in perimenopause because so much in that vulvar area changes so much. Here’s what every woman navigating midlife needs to know about vulvar changes, symptoms, and real solutions.
What Happens to the Vulva During Menopause?
Declining estrogen in menopause affects the entire vulvovaginal area, not just the vagina. Here’s what’s happening under the surface:
- Thinning of vulvar skin and tissues (called vulvovaginal atrophy or GSM)
- Reduced blood flow and elasticity
- Decreased natural lubrication
- Increased sensitivity to soaps, detergents, and friction
These changes are common but not “just aging”—and you don’t have to put up with discomfort.
Common Symptoms to Watch For
- Dryness, itching, burning, or rawness
- Pain with intimacy or exercise
- Small tears, cracks, or color changes
- Frequent urinary tract infections (UTIs)
- Recurrent yeast or bacterial infections
If you notice any of these, you’re not alone—studies show up to 80% of menopausal women experience vulvar symptoms at some point.
Science-Backed Strategies for Vulvar Health
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Daily Gentle Cleansing
Use only water or a mild, fragrance-free cleanser on the vulva (never inside the vagina). - Avoid wipes, douches, or anything “antibacterial”—your vulva isn’t dirty, and harsh products disrupt natural pH. -
Moisturize Regularly
Apply a vulva-safe, fragrance-free moisturizer daily (think of it like face cream, but for your most sensitive skin). - Look for products specifically labeled for vulvar use - like pleasure pods; avoid petroleum-based or perfumed creams. -
Lubricate As Needed
Water-based or silicone-based lubricants reduce friction during intimacy, exercise, or even daily movement. - Apply before activities that cause chafing (e.g., cycling, long walks). -
Wear Breathable, Soft Fabrics
Cotton underwear and loose clothing help prevent irritation and promote healing. -
Check In With Your Provider
Any persistent pain, sores, or color changes deserve a medical evaluation—don’t self-diagnose or ignore symptoms.
When Home Care Isn’t Enough
If OTC products aren’t helping, prescription options like low-dose topical estrogen or non-hormonal therapies may be appropriate. Vulvar pain, persistent irritation, or changes that don’t resolve should always be checked by a healthcare professional.
The Role of Pleasure Pods
Once you’ve got the basics covered, consider how intentional pleasure and self-exploration can support vulvar health. “Pleasure pods” (think: routines or spaces for gentle touch, self-care, and comfort) can increase blood flow, boost tissue health, and help you reconnect with your body—making midlife a time of empowerment, not embarrassment.
Amanda Otterman,
RN, Certified Hormone &
Menopause Specialist