How Does Your Vagina Change With Age?

The vagina changes with age, just like the rest of your body. Hormonal changes over time affect the way your vagina feels, functions, and looks. These hormones are suppressed during prepuberty. An increase in estrogen causes the vulva (external female genitals) to change during puberty, or sexual maturation, around age 10–14. Pubic hair begins to grow and becomes thicker and curlier as you age.

Your body starts producing less estrogen as you enter perimenopause during your 40s and 50s. Perimenopause is the transition period before menopause. Most people enter menopause around age 52. Decreased estrogen may cause vaginal dryness and painful sex. You may also notice lower libido due to fatigue, pain, and stress post-menopause.

You can typically manage these changes at home, but reach out to a healthcare provider if you are concerned about vaginal changes or have discomfort. Read on to learn how your vagina changes with age and how to manage these changes.

1. Increased Infection Risk

Aging affects the natural balance of "good" and "bad" bacteria in the vagina. This change can increase your risk of infections like bacterial vaginosis (BV) and urinary tract infections (UTIs). BV is excess bacteria growth in the vagina. UTIs are an infection of the urinary tract, which includes the bladder, kidneys, ureters, and urethra.

See a healthcare provider if you have itching or foul-smelling discharge. You may have a vaginal infection that requires treatment.

2. Lower Libido

Your libido, or sex drive, may change with age. Fluctuating hormones due to birth control use, pregnancy, and menopause can affect libido. Research has shown that some females in their 20s and 30s who use birth control may experience lower libido than others.

Sex drive often peaks during your mid-30s and early 40s, or when fertility begins to decline. You may notice your libido lowers, in contrast, when you enter perimenopause in your mid-40s. Estrogen steadily decreases this time, which causes vaginal dryness. A lack of lubrication may result in painful sex.

Post-menopausal people may also experience a reduced sex drive. Research has found that body image, fatigue, pain, and stress contribute to lower libido.

3. Pelvic Floor Weakens

Most people who become pregnant experience their first pregnancy between their late 20s and 30s, which can affect how the vagina feels and looks. Pregnancy and childbirth can stretch and weaken the pelvic floor. These muscles support your bladder, bowels, vagina, and uterus. The pelvic floor can also stretch and tear during childbirth to allow the baby's head to come through the birth canal.

Many people notice that during sex, their vagina feels slightly looser than before. This is known as vaginal laxity. The vaginal muscles are elastic, so they will eventually return to normal after pregnancy and childbirth.

Decreased estrogen levels can make the vaginal tissue thinner and less elastic during perimenopause. You may also notice changes in the appearance of the vulva (external female genitals) after menopause. The clitoris may shrink. The labia may become less full, potentially changing in color and starting to sag.

A decrease in collagen may contribute to sagging skin all over your body, including the vulva, and weaker pelvic floor muscles.

4. Pubic Hair Changes

Pubic hair growth begins during puberty, which typically occurs between ages 10–14. The hair increases, thickens, and becomes curlier as you age. Pubic hair may turn gray and thin as you approach menopause. Body hair is less likely to turn gray than the hair on your scalp.

5. Sex Feels Different

You may notice that sex feels different as you age and approach menopause, in addition to a decreased libido. Decreased estrogen levels cause the vaginal wall to shrink and become dry, resulting in painful sex.

6. Vaginal Discharge

The vagina starts to produce discharge around puberty. The hormones estrogen and progesterone course strongly through your body during your late 20s and 30s. You may notice increased vaginal discharge during this time.

7. Vaginal Dryness

Fluctuations in estrogen after pregnancy and when breastfeeding can lead to uncomfortable vaginal dryness. Some birth control methods may also lead to vaginal dryness. These changes are generally temporary, but they can result in painful sex.

Estrogen maintains collagen in the vagina, which helps cells create lubrication. Decreased estrogen during perimenopause often results in less lubrication. Your vagina may feel dry, sore, and irritated, especially during sex. You are more likely to have vaginal dryness and thin vaginal tissue (vulvovaginal atrophy) once you hit menopause and your period stops.

How To Manage Changes

It's normal for your vagina and vulva to change as you age. Here are some ways to manage these age-related changes:

• Apply topical estrogen: Supplemental estrogen cream can help relieve dryness and keep vaginal tissue thick and elastic. The body better absorbs a low dose of these methods than oral hormones.
• Continue having sex: The more you have sex, the easier it is to keep having sex if you have perimenopause or menopause symptoms. The vagina can become rigid and vaginal tissue less elastic when you do not have sex. Continue having sex to increase blood flow and keep vaginal tissue healthy.
• Do Kegel exercises: Try strengthening your pelvic floor with Kegel exercises. These involve clenching and releasing the pelvic floor muscles. Research has shown that doing Kegel exercises consistently after childbirth can improve blood flow and strengthen the vagina.
• Stop smoking: Smoking can decrease estrogen and blood flow to the vagina, worsening dryness and thinning tissue.
• Try a vaginal moisturizer: This rehydrates vaginal tissue and imitates vaginal fluid to help with itching, irritation, and painful sex. You can apply vaginal moisturizers daily or at least every two to three days, even if you are not having sex.  
• Use lubricant: Lubricants can make sex more comfortable if you have vaginal dryness. These products mimic the fluids lost from vaginal dryness, reducing friction that leads to pain and discomfort. There are many lubricant options, including water-, silicone-, and oil-based products.

Keep in mind that estrogen supplements are not suitable for all people, such as those with or who have had breast cancer. Supplements are also minimally regulated by the Food and Drug Administration (FDA). The effects of estrogen supplements vary from person to person and depend on the dosage, frequency of use, and interactions with current medications. Talk to a healthcare provider before starting any estrogen supplements. They can help assess your risk factors.

When To Contact a Healthcare Provider

Talk to a healthcare provider if you are worried about vaginal changes or experiencing pain and discomfort. Other signs to contact a healthcare provider include:

• Abnormal vaginal discharge (e.g., thick, white discharge)
• Burning when urinating
• Cloudy or bloody urine that smells foul
• Fever
• Itching, redness, and soreness of the vulva
• Lower abdomen or back cramps
• A strong urge to urinate

It's normal for the vagina to change as you age, but that does not mean you have to be uncomfortable. A healthcare provider can help you figure out the best course of action to address your concerns.

A Quick Review

You'll experience different vaginal changes as you age. These changes include increased vaginal discharge in your 20s and 30s but less elasticity in vaginal tissue in your 40s and beyond. There are ways to help keep your vagina healthy. Try doing Kegel exercises and using lubricants or a vaginal moisturizer. Consult a healthcare provider if you have concerns about your vaginal health.