How vaginas change with age and why it's normal, according to an expert

Just as your skin and hair change at different stages of your life, so does your vagina.

But what exactly are these changes, and how can you adapt your personal care to make sure your vagina is as healthy as possible, whatever your age?

Valentina Milanova, women’s health expert and founder of Daye, a gynaecological health company that offers products and services for period pain, at home STI testing and treatment for vaginal infections, explains the changes that take place at different stages of your reproductive life.

When you start your periods

"As you start your menstruating life, the vagina becomes more acidic," says Milanova. "And the vaginal walls thicken due to hormonal changes. This leads to the start of production of vaginal discharge."

"Your vaginal discharge is a valuable source of information about your gynaecological health. It can tell you if you have a vaginal infection through the discharge becoming grey or green, and it can tell you if you are ovulating, which is when the discharge becomes stretchy and similar to an egg yolk."

During and after pregnancy

"The vagina becomes more elastic to accommodate childbirth and usually increases in size during preparation for delivery," says Milanova. "It then returns to its normal size about two years post-vaginal birth."

"In addition, when you are pregnant, your vaginal discharge thickens, and you produce a mucous plug, which prevents harmful pathogens from entering through your cervix and hurting your developing foetus."

She adds that hormonal fluctuations during and after pregnancy can affect the elasticity of the vagina and also the moisture levels.

During perimenopause and menopause

"The vaginal walls become thinner, less elastic and drier due to decreased oestrogen levels during perimenopause and menopause," explains Milanova.

Depending on severity, this can be diagnosed as 'vaginal atrophy'.

"This (the dryness and sensitivity) can lead to discomfort and even tearing of the vaginal wall plus increased risk of infections such as bacterial vaginosis and urinary tract infections (UTIs)," adds Milanova.

In addition, "during menopause, your vagina becomes less acidic and your natural production of lactobacilli decreases," she says.

"Lactobacilli are the friendly bacteria that make up your vaginal discharge and serve as the immune system to your reproductive tract, fighting off those pathogens that cause vaginal infections."

"This is why it’s important to consider probiotic supplementation during this period or to increase your intake of probiotic-rich foods, such as kefir and kimchi, but also leafy greens."

"All of these foods help the diversity of microbial populations in your vaginal microbiome," says Milanova, "which is in turn, associated with a whole host of health benefits" not related to your vagina.

She adds that probiotic supplements can do the same job.

Due to the changes in the moisture levels and elasticity of the vagina during perimenopause and menopause, explains Milanova, some women may experience decreased sensitivity. "But others may actually notice hyper-sensitivity, which can lead to painful sex."

Or, of course, for some women, this can actually mean more enjoyable sex!

Using a lubricant can help with dryness and painful sensitivity.

STIs and vaginal infections

"Women are more at risk of STIs and vaginal infections at different stages of their lives," says Milanova. The risk of STIs, infections and vaginal warts will vary at different life stages. "For instance, adolescents and young adults are at higher risk, simply due to more sexual activity."

"Interestingly, people over 65 are also at a higher risk of STIs as some members of this group engage in unprotected sex due to not having worries about getting pregnant."

"During menopause, the decline in oestrogen levels can lead to changes in the vaginal environment, including a reduction in lactobacilli levels – those friendly bacteria levels, potentially increasing the risk of STIs, vaginal infections and UTIs."

What about lubricants and feminine hygiene products?

"Lubricants can be beneficial, especially during menopause when natural lubrication decreases," says Milanova.

"However, the use of feminine washes/vaginal cleansers/douches or other feminine hygiene products should be avoided as these tend to disrupt the natural pH levels of the vagina and can increase the risk of infection."

How do vaginal changes affect sex?

As mentioned above, "The ageing vagina can make sex more painful, due to decreased elasticity, moisture, and potential hypersensitivity," says Milanova.

"Open communication with a partner and using lubricants can help but also, hormonal replacement therapy (HRT) can help restore your hormonal balance, which will have a positive impact on both your vaginal health and your sex life." So that’s a win-win!

Vaginal health tips

There’s plenty you can do to care for your vagina at different stages of your life.

"Ensure you keep up with your scheduled pap smears and regular STI testing is also vital, as up to 70% of STIs, including chlamydia and HPV, can be asymptomatic," says Milanova.

"Diagnosis is really important, because if left undetected and untreated, chlamydia can cause inflammation in the reproductive tract, miscarriage, pre-term labour and ectopic pregnancy, as well as chronic pelvic pain."

"If left unmonitored, high-risk HPV strains can evolve into cervical cancer."

For optimal vagina health, consider your daily washing routine too. "Only use warm water and mild soap to wash the outside of your vulva, never the vagina," she advises.

"During menopause, focus on moisturising and using lubricants to tackle some of the increased discomfort and vaginal sensitivity you may be experiencing."

"Maintain a diet rich in probiotic foods; and find yourself an empathetic doctor or sexual health specialist to support any specific condition you may develop."

"Lastly, engage in pelvic floor exercises to maintain pelvic tone and ensure the proper functioning of your pelvic muscles and reproductive tract."

The most recommended pelvic floor exercise is what’s known as the 'Kegel exercise', which involves repeatedly contracting (as if you are trying to hold in a wee), and then relaxing the muscles that form part of the pelvic floor.

"Core exercises, pilates, barre and weightlifting can also support a strong pelvic floor," says Milanova.

Read more:

Sexual health doctor reveals the six questions you should ask a new partner (Yahoo Life UK, 6-min read)

How to be a better lover in six simple steps (Yahoo Life UK, 3-min read)

How many women orgasm during sex? The true number is astonishing (Yahoo Life UK, 4-min read)