Have you ever asked an older female family member or friend how their vulva changed as they aged? We are guessing probably not!

This may even be one of the few remaining topics between women that’s still a bit taboo to discuss.

If you haven’t noticed any changes to your vulva yet, you may want to know what might lie ahead. But if you’ve already experienced a definite change, how can you describe what’s different, other than “it doesn’t feel like it used to down there”?

Dryness is something that is talked about, at least by menopause specialists (although we love nothing more than talking about vulvas and vaginas, so we probably don’t count). You may have also heard that women can experience vaginal irritation, soreness or maybe even pain around the time of menopause.

But how does the vulva actually change and do these changes have anything to do with some of these other symptoms?

We are on a mission to take the fear out of the genital unknown and explain three common changes to the vulva that we often see when helping women – using everyday language so we all know what we’re talking about.

Less plump labia

Your outer and inner labia (or lips) have fatty pads which give their plumpness and provide a nice cushion and protection to the more sensitive parts of the vulva. Around menopause and afterwards, there is a loss of the fat pads which make the labia look thinner and sometimes smaller. The outer lips may end up being smaller than the inner labia so the inner parts may become more visible and protrude. Have you noticed the feeling of your pants creeping in at the front more than they used to? This might be why… but nobody wants a front-wedgie!

Changes in sensitivity

The clitoris is probably thought of as the most sensitive part of the vulva but actually it’s part of a larger structure that’s formed by the inner labia on either side meeting up at the top providing a protective cover over the clitoris, known as the clitoral hood and all of this area plays a role in arousal. 

Around menopause, changes to the clitoral hood can affect how sensitive you are there. The change might mean you become more sensitive or you could become less sensitive. And as you can imagine, both changes bring their own challenges.

If the clitoral hood and clitoris are more exposed due to thinner labia, and you’re also more sensitive, you could be getting lots of sensations just from the position and movement of your underwear, or when you wipe yourself, or what kind of surface you sit on. If you’ve become less sensitive, there may be implications for how easily you feel stimulated sexually, for example.

More infections

Another part of your vulva that may change is the part you wee out of – the urethra to give it its proper name. Lying in between your clitoris and your vagina, this part may become more prominent and be more visible, protruding through the inner and sometimes the outer labia. If this is the case, the entrance to the tube you pee from comes into more direct contact with potential germs than when its tucked away out of sight. So this might lead to more urinary tract infections or UTIs, particularly after intercourse.

How can you minimise unwanted changes to the vulva as you age?

These changes are primarily due to the hormonal decline that happens around peri/menopause. Taking systemic HRT (the usual kind we mean like patches, gels, tablets) can help ward off these kinds of changes if started in perimenopause. 1 in 5 women taking HRT need additional help for their vulva/vaginas and their waterworks. If you’re noticing symptoms like vaginal dryness, irritation, changes to how and when you pee, or your vulva just looks or feels different, the most effective treatment is to use estrogen directly to the vagina and vulva. It is also important to use appropriate methods for washing, moisturising and lubricating

You can read more about local estrogen and how to care for your genitals our GSM guide

And it’s not all about estrogen!

Testosterone helps our vulvas too!

We have receptors for estrogen and testosterone in much of the tissue that makes up the vulva and vagina. Both of these hormones are crucial in keeping the look, feel and function of our vulva and vagina healthy and staying well.

Where loss of estrogen predominantly leads to less natural lubrication, thinning of the vulval skin and loss of elasticity, loss of testosterone also contributes to issues by influencing blood flow and nerve fibres (which will in term affect sensitivity). There are more testosterone receptors than estrogen receptors in the outer labia.

There is a vaginal treatment called Intrarosa that is different to other local estrogens as, once this pessary is inserted into the vagina, Intrarosa converts into both estrogen and testosterone.

Hopefully, you now have more of an idea of how the vulva can change and what you can do to mitigate any changes you want to avoid. Share this knowledge with your female friends and relatives so we normalise talking about this and fully accept our bodies as they come in all their varied looks, sizes and shapes.

There are some helpful sites that share galleries of different labia and vulvas. You might like to visit the Great Wall of Vulva, the Labia Library, or see Laura Dodsworth’s 100 Vaginas.

Last updated: May 2026