Itchy Vulva? Here’s Why It’s Happening and How to Fix It

Menopause has a way of announcing itself: hot flushes, night sweats, and mood swings. But one of its most persistent and frustrating side effects often goes unspoken—vaginal itching. If you’ve ever thought, “Why does my vagina feel like it’s on fire?” during menopause, you’re not alone. Thousands of postmenopausal women experience menopause symptoms like dryness and irritation, but it’s rarely discussed openly. It’s time we changed that.

Menopause isn’t just about mood swings and temperature changes—it’s a full-body experience. One of the most impactful (yet often ignored) shifts happens in the vaginal area, with the genitourinary syndrome of menopause (GSM) playing the lead villain. Let’s break it down and dive into why vaginal itching happens, what’s behind it, and how to take back your body.

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The Connection Between Menopause and Vaginal Itching

Genitourinary Syndrome of Menopause (GSM)

Let’s get one thing straight: vaginal atrophy, vaginal dryness, and itching aren’t something you should just “put up with” during menopause. These symptoms are part of genitourinary syndrome of menopause (GSM), a direct result of your body producing less estrogen. Estrogen does more than regulate your periods—it’s crucial for maintaining the health of your vaginal lining. When estrogen levels decrease, the vaginal tissues thin, the vaginal pH rises, and your body loses the natural moisture that keeps everything running smoothly. What’s left? Irritation, urinary tract infections, and discomfort.

As Dr. Ginni Mansberg explains, “Itching can be one of the symptoms of the genitourinary syndrome of menopause. The condition is driven by low estrogen in the vaginal and vulval areas, and the subsequent atrophy or shrinking of the cells of the vulva”(1). And while GSM is common, it’s not something you should have to endure without answers—or relief.

Why Vaginal Itching Happens During Menopause

Here’s the truth: Your vagina is not betraying you. As your estrogen levels decrease, so does your vagina’s ability to maintain its natural oils and moisture. Add the loss of elasticity, and you’ve got a vaginal canal that feels more like sandpaper than the comfortable, lubricated environment it once was. This breakdown of the skin’s “barrier function” makes the vaginal tissues more prone to irritation, leading to that infuriating itch(2).

But it’s not just the dryness. The pH of your vagina also changes, making it more alkaline, which means your body’s natural defense against infections is weakened. And the result? Urinary symptoms, vaginal burning, and increased discomfort(3).

Your body may be shifting gears, but that doesn’t mean you should just deal with it. Postmenopausal women deserve better than “grin and bear it.”

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Common Causes of Vaginal Itching After Menopause

Dermatitis: The Leading Cause of Vulvar Itching

Vulvar dermatitis is often behind that persistent itch. What is it? Essentially, it’s skin inflammation, and it’s more common than you think. Dr. Mansberg explains, “The most common cause of an itchy vulva is vulvar dermatitis. Symptoms often go beyond itching to extreme rawness, stinging, burning, and pain”(2). If you have sensitive skin, or deal with hay fever or asthma, your vulva might be more prone to this inflammation. Unfortunately, everyday products like soap, perfume, and even silicone-based vaginal lubricants can make it worse.

And if you’re thinking, “Well, I’ll just wash it more,” think again. Soap dries the vulva even further, making the skin more alkaline, and that throws your whole system off balance. Even the chemicals in pads, underwear, and creams can be to blame(2).

The solution? Start by ditching the irritants, switch to fragrance-free products, and let your skin breathe. In many cases, applying a simple ointment like petroleum jelly can help the skin heal. And if it’s not enough? Corticosteroid creams can help tackle the inflammation(2).

Lichen Sclerosus: More Than Just an Itch

Sometimes, the cause of itching goes deeper. If your itching is particularly intense and you notice white patches on your vulva, you might be dealing with lichen sclerosus. This chronic condition affects the vulva, and while rare, it’s one that requires your attention. Yes, it’s itchy, but more importantly, lichen sclerosus can increase the risk of vulvar cancer in 5% of cases(4).

Don’t panic—but do get checked. The treatment is simple: corticosteroids. Apply them regularly and follow up with your healthcare provider for ongoing monitoring. It’s not a one-and-done kind of condition—it requires attention and maintenance(4).

Could It Be Thrush?

We tend to think of thrush (also known as yeast infections) as a younger woman’s issue, but it can still affect you post-menopause, especially if you’re on hormone replacement therapy (HRT). Menopausal women have fewer estrogen-fed cells, which means less fuel for the yeast to thrive on, but that doesn’t mean thrush is completely off the table. If you’re noticing the tell-tale signs—itching, thick discharge—it’s worth checking in with your doctor(2).

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03

How to Treat Vaginal Itching and Restore Comfort

Hormone Replacement Therapy (HRT)

For many women, hormone replacement therapy (HRT) is a lifesaver when it comes to managing vaginal symptoms. Dr. Mansberg explains, “HRT has proved to be effective in fixing the symptoms. It restores the vagina’s normal pH levels, repairs healthy blood flow to the vulva and vagina, and increases the number of cells in the vaginal canal”(2).

Whether you go for systemic HRT or opt for local treatments like vaginal oestrogen creams or rings, these therapies are a proven way to combat vaginal atrophy symptoms like itching and discomfort(5).

Preventive Measures for Vulvar Health

While treatment is essential, let’s talk about prevention. Taking care of your vulva during menopause means more than just using the right products. Here are a few evidence-based ways to manage vaginal itching and maintain healthy, happy skin:

• Avoid irritating products: Stay far away from soaps, perfumes, and fragranced products—they’re just waiting to disrupt your vaginal balance.
• Wear breathable cotton underwear: Let your vulva breathe. Cotton underwear is key, as synthetic fabrics can trap moisture and increase irritation.
• Try antihistamines: Sometimes the cause of itching is allergies. If that’s the case, after consulting with a medical professional, an over-the-counter antihistamine can work wonders.
• Cold compresses: Ice packs or cold compresses can soothe uncomfortable symptoms like swelling and irritation(6).

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04

When to See a Healthcare Provider

Red Flags You Shouldn’t Ignore

If your vaginal itching doesn’t respond to home remedies or over-the-counter solutions, it’s time to call in the professionals. Persistent itching, unusual discharge, or white patches on your vulva could be signs of more serious conditions, like lichen sclerosus or even vulvar cancer. Don’t ignore it—check in with your GP, gynaecologist or dermatologist for regular monitoring(4).

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The Bottom Line: Stop Scratching, Start Healing

Menopause is a journey, and sometimes it throws a few uncomfortable detours your way—like vaginal itching. But here’s the deal: You don’t have to suffer in silence. Whether it’s from GSM, dermatitis, or something more serious, there are solutions. Take charge of your health, seek out the right treatments, and let your body heal. Because no matter your age, you deserve to feel comfortable in your own skin—and your vagina.