More Than Irritation
Understanding Vulval Itching In Menopause

Vulval pain and itching during menopause can feel both uncomfortable and confusing. Many women worry they are dealing with recurring infections, when in fact hormonal changes are often the underlying cause.

Why the vulva matters in menopause

• The vulva is the external part of the female genitalia – it includes the labia, clitoris, and surrounding skin.

• During menopause, this tissue can become thinner, drier, and more sensitive due to falling oestrogen levels.

• Many women accidentally say “vagina” when they mean vulva, which can cause misunderstandings in consultations. Knowing the right terms helps you describe symptoms clearly.

How common are vulval symptoms?

• Studies suggest up to 50% of women experience vulval discomfort linked to menopause.

• Itching, soreness, and pain are often reported, but many women delay mentioning these to a GP.

• A UK survey found fewer than one in three women had ever discussed vulval health with a clinician – mainly because of embarrassment.

Wrap-up: Vulval discomfort is not rare, and it is not something to feel shy about. Explicit language and awareness are the first steps to understanding what your body is telling you.

Want to know why these changes happen and what can be done? Read on to explore the underlying causes of vulval pain and itching in menopause.

When oestrogen levels fall during menopause, the body responds in ways that can feel surprising and, at times, distressing. The vulval skin and tissues are susceptible to these hormonal shifts, which is why pain, burning, and itching often emerge at this stage of life.

Hormonal changes: the root trigger

• Oestrogen helps keep vulval and vaginal tissues thick, elastic, and well-lubricated.

• As levels decline, the skin becomes thinner and drier, making it more prone to irritation.

• This process is part of a condition called Genitourinary Syndrome of Menopause (GSM), which can also affect bladder health.

Skin and nerve sensitivity

• Reduced natural oils can cause microscopic cracks in the vulval skin, leading to stinging or itching.

• Some women develop heightened nerve sensitivity, where even light contact from clothing feels uncomfortable.

• This isn’t “all in your head” – nerve endings can genuinely become more reactive as tissues change.

Other contributing factors

• Repeated use of antifungal creams for presumed thrush can sometimes worsen irritation.

• Everyday triggers like perfumed soaps, tight gym leggings, or certain laundry detergents may also aggravate symptoms.

• Stress and reduced sleep during menopause can lower the body’s resilience, making discomfort feel sharper.

Menopause isn’t the only factor, but falling oestrogen sets the stage for many of these changes. External irritants or nerve shifts then add to the discomfort.

Not all vulval symptoms in menopause are the same. Some are directly due to hormonal shifts, while others are caused by specific skin conditions or nerve-related pain. Understanding which applies to you is the first step towards effective treatment.

Genitourinary Syndrome of Menopause (GSM)

• GSM is the umbrella term for changes caused by low oestrogen affecting the vulva, vagina, and urinary tract.

• Symptoms include dryness, itching, soreness, burning, and pain during intimacy.

• Many women mistake GSM for thrush, but unlike thrush, it does not usually improve with antifungal creams.

Vulvodynia: chronic vulval pain

• Vulvodynia refers to persistent vulval pain without an apparent visible cause.

• The pain may feel burning, stinging, or raw, and it can last for months or years.

• Diagnosis is often delayed, as symptoms can be confused with infections or dismissed as “just part of menopause”.

Vulval skin conditions that worsen with age

• Lichen sclerosus is a long-term skin condition that can cause severe itching, thin white patches, and scarring.

• Other issues, such as eczema or psoriasis, may flare during menopause due to increased skin sensitivity.

• These conditions require proper diagnosis and often medical treatment, not just over-the-counter creams.

Wrap-up: While GSM is the most common cause, vulval discomfort during menopause isn’t one-size-fits-all. Pinpointing the proper condition is crucial for lasting relief.

If you recognise your own symptoms here, the next step is looking for a proper diagnosis. Let’s explore what to expect when you speak to your doctor.

If vulval pain or itching keeps coming back, it is important not to self-diagnose or keep cycling through over-the-counter creams. A proper medical assessment can save months – even years – of frustration and help you find treatments that genuinely work.

When to see a doctor

• Seek help if symptoms persist beyond a couple of weeks, even if they come and go.

• Red flags include bleeding, visible skin changes, or severe pain.

• Early diagnosis of conditions like lichen sclerosus is vital, as untreated cases can lead to scarring or complications.

What to expect in an appointment

• A GP or menopause specialist will usually start with a detailed history of your symptoms.

• They may examine the vulva and vagina, checking for dryness, thinning, or skin changes.

• Swabs or tests may be taken to rule out infections such as thrush or bacterial vaginosis.

• If needed, you might be referred to a dermatologist, gynaecologist, or a menopause clinic for specialist care.

Overcoming embarrassment

• Many women delay seeking help because of awkwardness. Remember, doctors deal with vulval health every day – it is not unusual or shameful.

• Writing down your symptoms beforehand can help you feel more confident.

• Some women bring a partner or friend for support, while others prefer to attend alone.

Wrap-up: Diagnosis is not just about ruling things out; it is about getting the clarity you need to move forward with the proper treatment.

Once a diagnosis is made, there are several effective treatment options available – from hormonal creams to lifestyle adjustments. Let’s look at what works best.

Once a precise diagnosis is made, the focus shifts to relief. The good news is that vulval pain and itching during menopause are highly treatable, and options range from hormone-based therapies to simple lifestyle changes you can start today.

Local oestrogen treatments for direct relief

• Vaginal creams, tablets, or rings deliver low-dose oestrogen directly to the tissues.

• These improve thickness, elasticity, and moisture in the vulval and vaginal area.

• Because the hormone is applied locally, it has minimal impact on the rest of the body.

Systemic HRT and when it helps

• Full-body hormone replacement therapy can improve vulval symptoms alongside hot flushes, night sweats, and mood changes.

• Best for women with multiple menopause symptoms beyond vulval discomfort.

• You'll need to have an individual risk-benefit discussion with your doctor.

Non-hormonal moisturisers and lubricants

• Regular vaginal moisturisers can help maintain comfort and prevent irritation.

• Lubricants reduce friction during intimacy, easing pain linked to dryness.

• Please be sure to look for fragrance-free, pH-balanced products designed for sensitive areas.

Everyday lifestyle adjustments

• Wearing cotton underwear and avoiding tight clothing reduces friction.

• Switch to fragrance-free washing products to minimise irritation.

• Staying hydrated and managing stress can help reduce the intensity of symptoms.

Wrap-up: Whether you choose hormone therapy, non-hormonal products, or a combination, there are proven solutions to ease discomfort and improve quality of life.

Treatment is only part of the picture – coping day-to-day, in relationships and in your own confidence, is equally important. Let’s explore what that looks like.

Medication and creams can ease symptoms, but living with vulval discomfort touches so many parts of life – from intimacy to self-confidence. Coping well often means adding emotional support, lifestyle tweaks, and open conversations alongside treatment.

Managing intimacy and relationships

• Pain during sex can cause frustration or avoidance, but it is not the end of intimacy.

• Honest conversations with partners reduce pressure and help rebuild closeness.

• Using lubricants, taking more time for arousal, or exploring other forms of intimacy can all make a difference.

Supporting your mental health and self-esteem

• Constant itching or soreness can leave you irritable or anxious, even if you hide it well.

• Some women feel embarrassed about their bodies changing, which can chip away at confidence.

• Talking therapies, mindfulness, or even something as simple as journaling symptoms can help restore perspective and control.

Finding support and trusted resources

• Specialist menopause clinics, women’s health physiotherapists, and dermatologists offer expert guidance.

• Charities such as The Menopause Charity and the British Menopause Society provide evidence-based advice.

• Online communities can help, but always balance shared stories with professional medical input.

Wrap-up: Coping well is about more than symptom management – it is about protecting your confidence, your relationships, and your peace of mind.

Remember, you are not alone in this. The final section brings everything together with reassurance and practical next steps.

Vulval pain and itching in menopause are rarely spoken about openly, yet they touch the lives of so many women. What feels like an inconvenient irritation can, over time, affect sleep, confidence, relationships, and overall well-being. The key message is this: these symptoms are common, valid, and treatable. Understanding the role of hormonal changes, recognising potential conditions such as GSM or lichen sclerosus, and seeking proper diagnosis are all steps that put you back in control.

It is worth remembering that relief is not limited to one path. For some, local oestrogen therapy provides a noticeable difference within weeks. For others, non-hormonal moisturisers, lifestyle adjustments, or a combination of treatments are the right fit. What matters most is not ignoring the signs or dismissing them as “just part of getting older.” They are signals from your body, deserving of attention and care.

If any of this resonates, consider booking a consultation with a trusted GP or menopause specialist to explore your options. Or, if you are not quite ready for that step, start small: download a checklist to prepare for future appointments, or explore further resources from reputable menopause organisations. Whatever route you choose, know that you do not have to carry the discomfort in silence — support and solutions are within reach.