Your Vagina as You Age: 5 Normal Changes–and 3 to Get Checked

Your vagina is just like any other part of your body – and that means it can likely shift a bit from what it was like when you were 20. But it's also still not as common to talk openly about these new developments, even with your doctor. So it's fair to wonder: Which vaginal changes are normal as you get older – and which ones should raise an eyebrow?

The shifts to your vagina or genital area can run the gamut from harmless changes in appearance to hormone-driven ones that could lead to discomfort during sex or just in your daily life – and even some that can signal something serious about your health.

Ahead, gynaecologists explain why these vaginal changes occur, which are totally normal and the ones that may warrant a trip to the doctor.

What causes your vagina to change as you age?

Lots of it comes down to the same factors at play in plenty of other parts of your body. "Just like any other part of your body with skin, glands and hair follicles, the appearance of the vagina is affected by the ageing process and how well you care for it," explains Dr Sherry Ross, an obstetrician-gynaecologist and women's health expert.

And to be fair, our vulvas and vaginas go through a lot throughout our lives, and all of those experiences can add up, which is completely normal. "There are known [triggers], such as childbirth and normal hormonal changes – including perimenopause and menopause – that influence the integrity and elasticity of the vulva and vagina," Dr Ross explains.

The hormonal changes that come with those life events play a huge role. Many of the major changes are due to a loss of oestrogen during menopause – which happens when the area of our ovaries that makes the eggs stops producing oestrogen, according to Dr Mary Jane Minkin, a gynaecologist and clinical professor of obstetrics and gynaecology.

Because the vulva and vagina are packed with tons of oestrogen receptors, the decline in oestrogen over time can lead to changes in the tissue as it becomes thinner, drier and less elastic, Dr Ross adds. And your vagina may be affected by the same slowdown of collagen production that may change the appearance of your hair and skin elsewhere on your body, resulting in a loss of volume and firmness.

Vagina changes that are perfectly normal as you get older

You may experience dryness

One of the most common changes people experience is vaginal dryness – which can often result in uncomfortable or painful sex. We often hear about this happening after menopause, but it can also happen during other stages of life when our hormones are shifting.

"Oestrogen keeps vaginal tissue plump, elastic and naturally lubricated," Dr Ross explains. "When oestrogen levels drop or become erratic, whether from breastfeeding, perimenopause or menopause, the vagina and vulva both become more prone to dryness. This is one of the most common changes tied to hormonal shifts."

Luckily, dryness, while common, is treatable. "The good news is that not all of it is permanent," Dr Ross says. "Dryness related to breastfeeding typically resolves on its own once you stop breastfeeding and your hormones return to their baseline." Dryness from perimenopause and menopause is less likely to go away on its own, since oestrogen levels won't naturally go back up, but Dr Ross says it responds well to treatment. "Vaginal oestrogen and hormone therapy can both reverse existing dryness and help prevent it from progressing," she says.

The walls of your vagina may get thinner

Vaginal wall thinning is another by-product of declining oestrogen levels. "The skin becomes thin, loses its elasticity and appears paler," Dr Ross says. "During menopause, these predictable changes are called genitourinary syndrome of menopause."

That means you may not only be dealing with vaginal problems, but also bladder issues, according to Dr Minkin, which can lead to bladder infections and urinary tract infections if left untreated (more on that below). Luckily, many of these symptoms can be prevented or treated with the use of vaginal oestrogen, which helps restore the plumpness and elasticity you may have lost.

You may be more prone to infections

Higher oestrogen levels support the build-up of glycogen in the superficial cells of your vagina. This natural sugar is "a necessary food for the 'good guy' bacteria of the vagina," Dr Minkin says. As oestrogen levels drop, though, your vagina "loses its layer of superficial cells," she adds.

Without the glycogen stimulating the production of good bacteria in your vagina, you may become more prone to developing vaginal or urinary tract infections, which can be serious if not treated properly. Luckily, Dr Minkin says using a vaginal moisturiser or prescription vaginal oestrogen can help. That's because vaginal oestrogen can help replenish the oestrogen responsible for keeping the vagina moist and promoting the build-up of glycogen. "One very popular product these days that may help is hyaluronic acid vaginal suppositories," she adds.

You may notice vulvar drooping and other labial changes

Just like the skin on our faces can sag over time, leading to the appearance of jowls or wrinkles, the same can be true of our genital area. This is largely due to the collagen and elastin loss that happens as we get older. "Collagen and elastin exist in the skin all over the body, including the vulva," Dr Ross explains. "The labial skin of the vulva loses its collagen, fat and volume with ageing, making the skin droop and sag."

You may have less pubic hair

Hair growth cycles shift as you get older, so that follicles spend less time in an active growth phase and more time resting between growth cycles, according to Dr Ross. That's part of what causes hair thinning over time, and the same is true for pubic hair. "The slowdown between cycles means less hair is produced overall," Dr Ross says. In addition to noticing sparser hair, it's also normal to notice other changes in texture and appearance, like the hair "becoming thinner, shorter and less pigmented," according to Dr Ross.

Vagina changes that could be serious

Spotting after menopause

Dr Ross warns that any vaginal bleeding that occurs after menopause could be a cause for concern, especially if it's heavy, prolonged or irregular – but really, even if you notice it once, you should get checked out. "It always warrants a visit to your healthcare provider for a physical exam and a pelvic ultrasound to identify the cause," she says. "Most causes turn out to be benign, but ruling out vaginal or uterine pathology is essential before assuming it's nothing."

Skin changes

Just like other areas of the body, the vulva is full of hair follicles and sweat glands. That means it's possible to develop folliculitis, skin boils, pimples and other dermatitis conditions. If you notice any unusual lumps, bumps or sores, Dr Ross says it may be worth getting them checked out.

Similarly, she says any persistent itching or colour changes of the vulva and vagina are worth a visit to the doctor. "Some changes can be a normal sign of ageing, while others may be a sign of a skin condition like lichen sclerosus or cancer," she explains.

Vaginal bulge

"Feeling persistent pressure, heaviness, pulling in the vagina, or urinary and bowel [problems] can be a sign of a vaginal prolapse," a condition in which weakened pelvic floor muscles from childbirth, ageing, chronic coughing or obesity cause organs like the uterus, bladder or rectum to sag or bulge.

The bottom line

Just like any part of your body, it's totally normal to notice changes in your vagina and vulval areas as you get older. But that doesn't mean you have to live with discomfort or be left wondering what's worth a trip to the doctor. Most changes you may be experiencing have effective treatment options, and more concerning issues can often be caught early by your GP or gynaecologist.

"Seeing your provider yearly and getting regular pelvic exams ensures you're receiving the best medical care," Dr Ross says. "Empower yourself and your vagina to go sooner rather than later when unexpected symptoms of the vulva and vagina occur." Dr Minkin agrees. "Don't be uncomfortable or be set up for further problems: Get some help!"