Clinics in Plymouth & Wells

October 2023

What is the menopause?

Menopause is the natural biological process which concludes a woman’s reproductive years. It is a significant event that affects every woman differently. During this transitional phase, hormonal changes occur, impacting various aspects of a woman’s body, including the vagina.

Contrary to popular belief, it doesn’t have to be like this. Menopause is not something women need to “Hold on and get through”. Sadly, we have been sold that information by a male-dominated medical hierarchy, but things are changing!

In this blog we will explain the hormonal changes that occur from childhood to post-menopause and discuss how they affect the vagina. By reading, you will understand how hormones impact a woman’s body, and appreciate the long term affects these hormones have on the second half of your life. But more importantly, what can be done to relieve symptoms.

How do female hormones change from childhood to the reproductive years?

The hormonal changes that occur during a woman’s life are significant and play a crucial role in physical and reproductive development. Here’s an overview of these hormonal changes through various life stages:

  • Childhood (pre-puberty):
    • Oestrogen and progesterone levels are low, as the reproductive system is not fully developed.
    • Vaginal tissues stay relatively inactive and underdeveloped.
  • Puberty:
    • Oestrogen production increases, triggering breast development, the growth of pubic hair, and the onset of menstruation.
    • Vaginal tissues become more active and prepare for potential reproductive processes.
  • Reproductive Years:
    • Oestrogen and progesterone levels fluctuate during the menstrual cycle, causing changes in the ovaries, uterus, and breasts.
    • Vaginal tissues maintain their health, elasticity, and moisture due to adequate hormone levels.
    • From mid 30s, our oestrogen levels begin to slowly decline, which has a knock-on effect to collagen and elastin formation- important proteins for the skin, this is why so many people feel they suddenly age in their 40s.

What happens during the menopause and how does it affect the vagina? 

The average age at which menopause typically starts is around 51 years old. However, menopause can occur at various ages, and the timing can vary from woman to woman.

  • Perimenopause:
    • During this transitional phase, typically starting in a woman’s 40s, but can be much earlier, hormonal fluctuations become more pronounced.
    • Oestrogen and progesterone production starts to decline, leading to various premenopausal symptoms.
    • Vaginal tissues begin to experience changes, including decreased elasticity, dryness, and thinning of vaginal walls. When Dr Sarah Jenkins worked as a GP women would present to her with a change to discharge, smell, or think they had recurrent thrush due to burning sensation and vaginal irritation – but all swabs taken would be negative for infection.
    • At this stage women can have over 1000 different symptoms ranging from bloating, sudden anxiety, joint pains, headaches… it’s not just about changes to periods. For more in depth and reliable info, please look at and use their symptom checker to work out where you fit.
  • Menopause:
    • The medical definition of the menopause is when a woman has not had a menstrual period for twelve consecutive months.
    • At this point, oestrogen levels significantly drop, causing further changes in the vaginal tissues.
    • Lack of oestrogen leads to a condition known as vaginal atrophy, where the vaginal walls become thinner, drier, and less elastic.
    • Reduced blood flow to the vaginal area may also occur, affecting lubrication and increasing discomfort during sexual intercourse.
  • Post-Menopause:
    • Once a woman enters post-menopause, the hormones have depleted. This affects the whole woman, e.g bone health, urinary symptoms, skin laxity, aging.
    • Vaginal dryness and atrophy persist but can be managed through various treatments, including hormone replacement therapy and vaginal moisturisers.

And remember ladies, at all stages of menopause, you become more susceptible to recurrent urinary infections because of the aging process. Doctors call this the genitourinary syndrome of menopause.

How can I manage Vaginal Changes in Menopause?

The changes described above can seem daunting and upsetting, however there are plenty of ways to manage the changes and symptoms, such as:

  • Regular Sexual Activity:
    • Engaging in sexual activity helps promote blood flow to the vaginal area, improving its health and elasticity. Labia can fuse and the clitoris can atrophy so increasing the blood flow to the region, just like any other organ is healthy, not to mention the benefits pleasure gives to the brain via endorphins and other neurotransmitters.
  • Lubricants and Moisturisers:
    • Water-based lubricants or vaginal moisturizers can help alleviate vaginal dryness and provide immediate relief.
  • Hormone Replacement Therapy (HRT):
    • For women experiencing Menopausal symptoms, HRT is recommended to replenish hormone levels. Did you know Dr Strawford offers a Bioidenitcal hormone service for men and women at Skin Excellence Clinics? A fully comprehensive consultation and medical history is required – please email or call to book.
    • Oestrogen supplementation through creams, patches, or pessaries can help restore vaginal health, and are often used in combination with the treatments we perform.
  • Lifestyle Changes:
    • Maintaining a healthy lifestyle by eating a balanced diet, staying physically active, and managing stress can have a positive impact on overall hormonal balance.
    • Taking collagen supplements is also important to boost depleted production. We stock the best product at Skin Excellence Clinics – “Totally Derma”.

How can Skin Excellence Clinics help manage my menopause symptoms?

EMPOWER Treatments by Inmode

The modules in the Empower RF system include the following:


V-tone has been proven to tighten the pelvic floor muscles which change during menopause and after childbirth. Even if you had a c-section, the extra weight of a baby in the abdomen affects the ligaments and muscles in the pelvic and abdominal region. The V-tone essentially gives the muscles a workout, just like a muscle in the gym which tightens up the pelvic floor and helps regain control over urinary leakage and urgency. If you can’t have a good belly laugh or jump up and down without a little accident – this is the treatment for you!

Forma V

This is a gentle treatment, suitable for all ladies who wish to improve their vaginal skin. For example, some women experience their labia minora rubbing and causing bleeding and discomfort. Following Forma V, patients have reported vaginal tightening, increased natural lubrication, reduced burning and itching sensation and a better aesthetic appearance. This treatment is also reported to improve haemorrhoids and fecal incontinence. A course of six treatments is usually required, once every two weeks.


Morpheus8V is a more invasive procedure, combining microneedling with radio frequency (heat-based treatment). Although this might sound unpleasant, there aren’t many nerve endings in the vaginal canal, so numbing cream is adequate to help manage any discomfort.

The needling and heat work together to cause controlled damage forcing the skin to produce collagen and elastin, the meshwork under the skin which holds it all together. This also contracts the skin to tighten it and improve the quality of the skin, as well as treating difficult medical conditions such as Lichen Sclerosus and Lichen Planus.

Patients report an improvement to bladder prolapses, urinary issues, burning and itching problems, recurrent thrush, recurrent UTI – all without the need of surgery!

When used on the external vagina, Morpheus8V improves sensitivity as it can safely be used on the clitoris and around the G-spot internally. Women who have difficulty to reach orgasm have said their ‘bits suddenly work’ and they are enjoying intimate relationships again.

Other Treatments Available


The O-Shot is a licensed procedure using PRP (Platelet Rich Plasma) derived from your own blood. PRP contains many growth factors to stimulate tissue repair and regeneration and is now widely used in medicine worldwide to treat many conditions. Dr Strawford is one of only a few doctors in the UK officially trained to undertake this procedure to help treat lack of sensitivity and loss of the ability to orgasm. The O-Shot can also help treat incontinence, vaginal pain, and scars, and is proven to help with the very painful and disabling condition of Lichen Sclerosis affecting the external genitalia. For more information visit the official O-Shot provider website:


We are excited to announce this medical breakthrough treatment and introduce it to Skin Excellence Clinics. This is a polynucleotide (PN) treatment, which is fragments of DNA injected into your skin to boost your own cells and renew them with these new DNA building blocks. The PN is combined with Hyaluronic Acid – just like facial fillers, which are known to plump up, hydrate and improve skin elasticity.

Studies in Italy have shown over 90% of women with symptoms of dryness, genitourinary syndrome of menopause, vaginal atrophy and/or soreness reported a drastic improvement majorly improving their quality of life.

As a simple injectable treatment, this may be the preferred treatment for women who have severe symptoms and want to improve their pelvic health prior to further treatments. NewGyn can be used as a standalone treatment (course of five required) or in combination with any of the Empower treatments we offer.


Understanding the hormonal changes that occur from childhood to menopause is essential in comprehending the effects on the vagina. While menopause brings about significant changes, such as vaginal dryness, atrophy and prolapse, there are various management strategies available. By staying informed and seeking appropriate treatments, women can navigate through this life phase with confidence and comfort. Remember, every woman’s experience with menopause is unique, so consulting with healthcare professionals is crucial for personalised guidance. Our team of medical experts are available to create your individualised treatment plan and improve your quality of life!

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