The (Totally Normal!) Ways Your Vagina Changes As You Age

Women using birth control pills in this decade (or before, or after!) might find themselves with a little vaginal dryness, Dweck says, possibly because the pill stops ovulation, which might limit natural lubrication around that time each month.

Another cause is complicated and a bit controversial, says Stephanie S. Faubion, MD, director of the Office of Women's Health at Mayo Clinic and author of Mayo Clinic—The Menopause Solution. "We think some women may get more vulvar dryness with birth control pills because the pills are blocking male sex hormones called androgens, and the vulva has androgen receptors." It's unclear, she says, why some women on the pill feel these effects and others don't.

Of course, other women may decide during this decade that it's time to populate the planet. Obviously, pregnancy (and childbirth) has a major impact on the vulva and vagina, but some of the changes common to the miracle of life are a little more surprising.

For example, some women will find themselves with varicose veins down there—yes, really—due to the heavy weight of their uterus while pregnant, Dweck says. These engorged blood vessels are more common late in pregnancy and right after delivery, she says. Pregnancy hormones might also change the color of your vulva, so don't worry too much about a darker hue appearing, she adds.

Luckily, "the vagina is a very forgiving place," Dweck says. Due to its elastic nature and rich blood supply, things tend to go back to normal shortly after giving birth. "It's still amazing to me even after all these years in practice," she says.

However, muscle and nerve damage can also occur due to the amount of force put on the pelvic floor muscles during pregnancy and labor, Faubion says. "Some physical therapists argue we should all get a little bit of instruction after having a baby," she says, to help rehab your way back to optimal pelvic health. For some women, pelvic floor exercises can help prevent incontinence down the road and keep sex sexy.

Menopause brings with it the most noticeable vaginal and vulvar changes, not to mention the ones women are most likely to bring to the attention of their doctors, Faubion says. Dwindling estrogen leads to thinner, less elastic, drier vulvar and vaginal tissue, which can make sex feel like using sandpaper and cause irritation that makes you feel like you need to pee. 

Recently, some medical experts have been campaigning for these changes to be formally referred to as genitourinary syndrome of menopause, or GSM, Faubion says. The name change (many used to refer to it as vaginal atrophy, which just sounds icky) isn't supposed to make you feel like you have a capital "S" syndrome, necessarily, but to draw attention to the fact that this cluster of vaginal, vulvar, and urinary symptoms accompanies menopause regularly. It's a reminder to women and their health care providers that there are ways to treat these symptoms, Faubion says. (More on treatment later!)

If you were to gaze at your privates with the help of a hand mirror, you might notice some obvious changes to the look of your vulva in this decade, as women lose fat and collagen that was there when estrogen was aplenty. "I tell women this is the one place on your body you want wrinkles and folds and the one place on your body you lose wrinkles and folds with menopause," Faubion says, as the thinner, less elastic skin can cause the whole area to, in a sense, shrink. 

When estrogen leaves the building, so do certain bacteria that make their home in the vagina, which changes its pH. When the vagina becomes more acidic, it might become more vulnerable to infection, Faubion says, but the loss of elasticity may also be to blame. Tiny tears can form more easily in a less lubricated, less flexible vagina, Dweck explains, making it easier to catch something.