Atrophic Vaginitis Isn’t One-Size-Fits-All: Why Symptoms Can Look Different for Every Woman

Why AV can feel so different from one woman to the next

Atrophic vaginitis (AV) refers to changes in the vaginal lining and surrounding tissue associated with low oestrogen. While the underlying driver may be similar, the day-to-day experience is not.

Some women notice dryness early. Others describe burning, irritation, tightness, or a sense of fragility that comes and goes. For some, symptoms feel mild but persistent. For others, they arrive suddenly and feel disruptive.

This range is common. There is no single “typical” experience of AV.

What shapes how AV shows up in real life

AV symptoms are influenced by more than hormones alone. They are shaped by everyday factors that differ from woman to woman.

1) How quickly oestrogen levels change

Gradual hormonal transitions can lead to slow, creeping changes. More abrupt shifts, such as after surgery or some cancer treatments, may feel more noticeable sooner. Neither pattern is more “correct” than the other.

2) Individual tissue sensitivity

Some women have always had more reactive skin. For them, even subtle tissue changes can feel uncomfortable. Others may not notice symptoms until dryness becomes more pronounced.

3) Day-to-day conditions

Heat, friction, clothing choices, exercise, swimming, travel, and hygiene routines can all influence comfort. Symptoms often fluctuate in response to these factors rather than remaining constant.

4) Personal reference points

If intimate discomfort is entirely new, it can feel alarming even when changes are mild. If sensitivity has come and gone over years, patterns may feel more familiar. Both experiences are valid.

What AV does not need to look like

There is no checklist that determines whether AV is “real enough” to matter.

You do not need to experience severe dryness, pain, or constant symptoms for AV to be worth addressing. Milder symptoms that linger, fluctuate, or quietly erode comfort are still significant.

If something feels different to your normal, it deserves attention.

Why comparison often creates more confusion than clarity

It is natural to compare your experience with friends, online discussions, or articles that describe AV in broad terms.

But AV is not linear. Some women plateau. Others fluctuate. Some improve with small changes. Others need more structured support over time.

Comparing experiences rarely helps. Understanding your own patterns usually does.

When a combined approach can make sense

Across the menopause transition, some women get the best day-to-day comfort from pairing two supports:

• Hydrating, protective emollients (often containing humectants such as hyaluronic acid) to help reduce dryness and friction and support surface comfort.
• Low-dose local hormonal therapies (where appropriate and prescribed) to address the underlying tissue changes linked to low oestrogen.

This is not an “either or” decision for everyone. For some, an emollient routine is enough. For others, adding low-dose local hormonal therapy improves tissue resilience over time, while ongoing moisturising support helps with the practical realities of comfort, movement, and routine triggers.

If you are considering combination support, it is worth discussing what is suitable for your history and life stage, especially if symptoms are persistent or escalating.

Finding an approach that fits your life

Because AV varies, there is no universal routine that works for everyone.

Many women start by noticing:

• When symptoms feel worse
• What seems to soothe rather than irritate
• Whether consistency feels better than reacting only during flares

A simple option across peri to post

Some women prefer a single, steady external support they can adjust as needs change.

V.supple® Balm can be used across the menopause transition from perimenopause through to postmenopause as an external moisturising comfort layer. The most practical adjustment is often not changing products, but changing frequency:

• During quieter phases: a lighter, maintenance rhythm may feel sufficient.
• During high-friction days, heat, travel, or flare-like periods: more frequent application can feel more supportive.
• When things settle again: many return to a lower frequency that still protects comfort.

The aim is not perfection. It is a routine that stays gentle, realistic, and responsive to your own patterns.

When it’s time to seek review

Variation is normal, but certain changes should prompt a conversation with a clinician:

• New bleeding
• Persistent or worsening pain
• Symptoms that do not settle with gentle care
• Changes that feel abrupt or concerning

If you have a history of cancer treatment or complex medical care, personalised guidance is particularly important.

A closing thought

AV does not follow a script. It responds to bodies, seasons, routines, and life stages.

If your experience looks different to someone else’s, that does not make it unusual. It makes it human.