The Link Between Menopause and Vaginal Itching

Menopause is a natural transition that all women go through, but it can bring along a host of unexpected symptoms. While hot flashes, night sweats, and mood swings are the most commonly discussed, many women experience symptoms that don’t get as much attention. One of these is vaginal itching — uncomfortable and frustrating, yet a surprisingly common symptom. Around one-third of postmenopausal women experience vaginal itching.

It's easy to assume that a yeast infection is behind that itchiness, but that's not always the case. So, think twice before reaching for the Monistat!

Understanding why this happens and what you can do about it can help you navigate this stage of life with more confidence and comfort. Keep reading to learn more about how menopause affects vaginal health, why vaginal itching is so common, and what to do about it.  

How menopause affects vaginal health

Menopause happens when your ovaries stop releasing eggs and your body’s production of the hormones estrogen and progesterone takes a major dip. Estrogen is super important for keeping different parts of your body healthy, including the vaginal and vulvar tissues. So, when estrogen levels decrease, it can lead to some noticeable changes and uncomfortable symptoms — known as genitourinary syndrome of menopause (GSM).

Vaginal dryness

One of the most common effects of reduced estrogen is vaginal dryness (often referred to as vaginal atrophy or atrophic vaginitis), which is a thinning and inflammation of the vaginal lining. About half of menopausal women experience vaginal dryness. This can lead to a variety of symptoms, including:

• Dryness: Decreased estrogen levels mean your body produces less cervical mucus (ie, less vaginal discharge). This reduced lubrication makes it harder for the vagina to stay moist and comfortable.
• Thinning of vaginal tissues: This can lead to increased sensitivity and irritation.
• Lower elasticity: The vaginal walls may become less flexible, making activities like intercourse or even simple movements uncomfortable.

As the vaginal walls become thinner, they become more vulnerable to external irritants, such as soaps, lotions, and even certain fabrics, which can exacerbate vaginal itching.

pH changes

The vaginal pH also changes with menopause. A healthy vaginal environment is typically slightly acidic, which helps maintain a balance of good and bad bacteria and limits the growth of harmful microorganisms. Estrogen supports this natural acidity, so when estrogen levels drop, the pH can shift, leading to a more alkaline environment. This change can disrupt the delicate ecosystem of your vaginal flora, making you more prone to irritation and vaginal infections that can cause vaginal itching.

Reduced blood flow

Estrogen helps keep the blood flowing to the vaginal area. When blood flow decreases, it can lead to the vaginal tissues not getting the nutrients they need. This might result in some dryness, discomfort, or vaginal itching. When the blood supply isn't quite enough, the natural healing and moisturizing processes of the vaginal tissue can slow down a bit. 

Urinary tract infections

Aside from vaginal changes, urinary tract infections (UTIs) also become more common during menopause, and they can sometimes cause itching.

The primary reason for this increased risk is the decrease in estrogen production, which leads to changes in the urinary tract, too. Lower estrogen levels can cause the tissues in both the vaginal and urethral areas to become thinner and less elastic, making them more vulnerable to irritation and infection. Additionally, a less acidic vaginal pH can disrupt the natural balance of bacteria and encourage the growth of harmful microorganisms that cause UTIs.

Itching can occur as part of the irritation caused by a UTI, especially if the infection has spread or if there is inflammation in the vaginal area.

Other common urinary symptoms in menopause include:

• A strong, persistent urge to pee
• Frequent urination
• A burning sensation when you pee
• Cloudy or strong-smelling urine
• Pelvic pain

If you’re experiencing itching along with these UTI symptoms, it could be a sign that the infection is affecting the surrounding tissues or that there is a coexisting issue, like vaginal dryness or irritation from menopause-related changes.

How to manage and treat vaginal itching

While vaginal itching during menopause can be uncomfortable, there are several strategies you can try to alleviate the symptoms.

Hormonal treatments

If you’re experiencing significant discomfort, consult your healthcare provider about treatment options. Hormonal therapies, such as low-dose estrogen creams, rings, or tablets, can help replenish vaginal moisture and improve vaginal health. You typically start by using vaginal estrogen daily for a few weeks then transition to twice weekly, but it can take a few months to see results. 

If you’re experiencing other menopause symptoms — like insomnia, night sweats, and hot flashes — your healthcare provider may recommend hormone replacement therapy (HRT). HRT is a prescription medication that contains either synthetic or bioidentical versions of the reproductive hormones estrogen and progesterone. HRT is available in various forms, including pills, gels, or patches. However, it's important to note that not everyone can take HRT, so it may not be the best option for you.

Vaginal moisturizers and lubricants 

Whether or not you choose to go down the hormonal route, vaginal moisturizers and lubricants can offer daily, targeted relief. 

Opt for a vaginal moisturizer designed for women experiencing menopause-related dryness — like Evvy’s Hyaluronic Acid Suppositories — and pH-balanced, water-based vaginal lubricants during sex.

If you’re experiencing vulvar itching, try Evvy’s Soothing Vulva Cream, a gentle topical cream formulated with prescription-grade hyaluronic acid, aloe, and vitamin E designed to relieve external burning, dryness, and irritation without hormones. 

Use gentle, fragrance-free products

Opt for unscented soaps, laundry detergents, and hygiene products to minimize potential chemical irritants. Strong scents and harsh chemicals can trigger an allergic reaction or worsen dryness and itching.

Choose cotton underwear

Cotton is breathable and helps wick away moisture, keeping the area dry and preventing further skin irritation. Avoid synthetic fabrics, as they can trap heat and moisture, creating an environment that supports bacterial and yeast growth. While switching to cotton underwear won’t treat vaginal itching, it’ll prevent it from getting worse and make symptoms more manageable. 

Regular checkups

Regular gynecological exams are important during menopause. Your doctor can help monitor your vaginal health and recommend the best treatment options based on your symptoms and medical history.

Taking an Evvy Vaginal Health Test can also help you monitor how this transition is affecting your unique vaginal microbiome. 

When to see a doctor

While some vaginal itching during menopause is common, it’s essential to seek medical advice if:

• The vaginal itching is severe or persistent
• You notice an unusual or strong odor, unusual vaginal discharge, or bleeding
• Over-the-counter treatments aren’t working
• You’re experiencing painful sex.

These could be signs of an underlying condition that may need medical attention, such as bacterial vaginosis (BV), a yeast infection, a sexually transmitted infection (STI), or more serious health concerns.

FAQ

How do you stop menopause itching?

If you’re experiencing dryness from menopausal symptoms, using vaginal moisturizers and lubricants designed specifically for this can really help! Look for fragrance-free and gentle products for your bathing and laundry needs—strong scents and harsh chemicals can irritate delicate vaginal tissue. Opting for breathable cotton underwear can also make a big difference by keeping the area dry and comfortable with better air circulation. If you’ve tried over-the-counter moisturizers or lubricants and are still feeling itchy, it might be worthwhile to have a chat with your doctor about hormonal treatments. Low-dose vaginal estrogen creams or rings can help replenish moisture, and there are also non-hormonal options that can provide relief without hormones. Don’t forget to schedule regular checkups with your doctor too — it's a good way to make sure everything is okay and that nothing more serious is behind the irritation.

How do you stop itching down there immediately?

There are several causes for vaginal and vulvar itching, including infections, allergies, and hormonal changes. When it comes to menopause-related itching, the primary cause is a decrease in estrogen, which can lead to dryness, thinning tissues, and pH changes that make the vaginal area more prone to irritation. To stop vaginal itching immediately, you can try using a soothing vaginal moisturizer or lubricant (such as Evvy’s Hyaluronic Acid Suppositories, designed to help restore moisture to the area and provide relief from discomfort). Applying a cool, damp cloth to the affected area can also help reduce itching and inflammation. When you’re showering or bathing, make sure to use gentle, fragrance-free products to avoid further irritation. If the itching is persistent and bothersome, ask your doctor about hormone therapy, which can help replenish moisture and support the health of the vaginal tissues, providing longer-lasting relief. Finally, if the itching doesn’t improve or is accompanied by other symptoms, reach out to your doctor to discuss treatment options tailored to your needs.

Does menopause cause pubic hair to itch?

Yes, and it often stems from the same changes that affect vaginal health. During menopause, the body’s production of estrogen declines, which can lead to a decrease in natural moisture levels and changes in the skin's elasticity. This decrease in moisture can leave the sensitive skin around your vulva feeling dry and more prone to irritation. As the skin becomes drier, it may become itchy, especially if the hair follicles or surrounding skin are affected by a lack of lubrication. Additionally, reduced estrogen can cause thinning and weakening of the skin, making it more sensitive to itching or discomfort. If you’ve noticed that your pubic hair is itchy, it could also be due to dryness, friction from clothing, or changes in pH levels, which can disrupt the balance of natural bacteria and lead to irritation. To ease itching, using gentle, fragrance-free moisturizers and avoiding harsh soaps or scented products can help. If the itching persists or becomes bothersome, it’s a good idea to consult your doctor to rule out any other underlying conditions and discuss potential treatments.