Menopause Vaginal Itching: Causes and What Helps

It might be a low, nagging itch around your vulva (the outer lips and the skin around the opening of the vagina). It might flare up at night, after a walk, or after a bath. Sometimes it comes with soreness, and it's hard not to scratch.

Menopause vaginal itching is common, and you're not imagining it. The NHS lists dryness, burning, irritation and itching in and around the vagina among the symptoms of perimenopause and menopause.

Falling oestrogen is often part of the reason. But an itchy vulva has other causes too, and a few need checking. This page explains what's usual, what isn't, and what can help.

See your GP if you have:

white, shiny or thickened patches of skin on your vulva. This can be a sign of lichen sclerosus, a skin condition that needs treatment
a sore, an ulcer or a lump on your vulva, including one that looks like a wart
red or dark patches, or a mole that changes shape or colour
bleeding that isn't a period, discharge with blood in it, or any bleeding after your menopause (see bleeding after menopause)
itching that doesn't go away

These signs are very common and usually have other causes. But they need checking (NHS vulval cancer symptoms, British Association of Dermatologists).

Why does menopause make your vulva itch?

It's mainly about oestrogen. A leaflet from Northern Devon Healthcare NHS Trust explains that with lower oestrogen, the skin of the vulva tends to become thinner and drier during and after the menopause. That makes it more likely to itch.

Women's Health Concern, the patient arm of the British Menopause Society, adds that the natural moisture in the vagina is slightly acidic. This helps keep the area healthy and helps protect against infections such as thrush. After menopause, the skin of the vulva and vagina becomes thinner and less stretchy, and the vagina can become dry.

Your doctor may call this vaginal atrophy, atrophic vaginitis or genitourinary syndrome of menopause (GSM). We explain more on our page about vaginal dryness in menopause.

Can perimenopause cause vaginal itching?

Yes. The Northern Devon leaflet says low oestrogen can start before the menopause itself, while you're still having periods. So itching can begin in perimenopause.

The itch-scratch cycle

Scratching gives brief relief, but it can make things worse. The British Association of Dermatologists notes that scratching can break the skin and make it hurt.

A 2024 UK guideline for sexual health doctors describes how long-term scratching can thicken the skin, which then itches more. It says heat, sweat, rubbing from clothes and harsh skin products can all feed this cycle. So can stress, in some people.

Is it thrush? Thrush and menopause

Many women reach for a thrush treatment first. Sometimes that's right. Often it isn't.

The NHS says the signs of vaginal thrush are:

white discharge, often like cottage cheese, that usually doesn't smell
itching and irritation around the vulva and vagina
soreness and stinging during sex or when you pee

Thrush becomes much less common after menopause. A 2022 review by a European expert panel says that when women after menopause do get it, it's mostly after antibiotics, with diabetes that isn't well controlled, or while taking HRT. The NHS also lists HRT, antibiotics and poorly controlled diabetes among the things that make thrush more likely.

Menopause changes can feel a lot like thrush. Women's Health Concern warns that some women assume it's thrush and buy treatments from the pharmacy, which can make the problem much worse. The 2024 UK guideline also lists antifungal creams among the products that can irritate vulval skin.

Persistent thrush: when to see a GP rather than the pharmacy

The NHS says you can buy thrush treatment from a pharmacy if you've been diagnosed with thrush before and recognise the symptoms. But it says to see a GP if:

it's your first time with thrush symptoms
you're over 60
you get thrush more than 4 times in 12 months
treatment hasn't worked
you have a weakened immune system, for example from diabetes

The NHS also says not to use thrush treatment more than twice in 6 months without advice from a pharmacist or doctor. A sexual health clinic can help too.

If you keep getting what feels like thrush, ask for a test. The 2022 review says confirming the diagnosis matters before long-term treatment. When tests for thrush come back clear, the itching may be from something else, such as lichen sclerosus.

Lichen sclerosus: the itch not to ignore

Lichen sclerosus is a long-term skin condition. The British Association of Dermatologists says it most often affects the vulva and the skin around the bottom, and it's most common after the menopause.

The signs can include:

itching, which is often the main symptom
pale, white, shiny skin, usually thinner than normal but sometimes thicker
skin that tears more easily
sex becoming painful as the skin scars and the vaginal opening narrows, if it isn't treated

It is not an infection. You can't catch it, and you can't pass it on through sex.

There's no cure, but the dermatologists say treatment with a steroid ointment usually controls it well. There is a small increased risk of skin cancer in the affected skin. They put it at under 5%, and say keeping the condition well controlled lowers it. That's why it's worth getting any white, shiny or thickened patch checked, and not just living with the itch.

Other causes of an itchy vulva

It's not always the menopause. Other common causes include:

Irritation from everyday products. The 2024 UK guideline lists soap, shower gel, bubble bath, bath oils, douches, intimate deodorants, talc, pads, panty liners, wet wipes, perfumed toilet paper, biological washing powder, fabric conditioner and antiseptic washes. Condoms, lubricants and spermicides can also irritate.
Friction. Tight or synthetic underwear, cycling and horse riding can all rub.
Moisture on the skin. Urine, sweat and discharge can irritate. If you leak urine, the Northern Devon leaflet says this is a very common problem and worth raising with your GP.
Skin conditions, such as eczema, psoriasis or lichen planus.
Some sexually transmitted infections, which Women's Health Concern says can cause similar symptoms.

If you're itchy all over, not just down below, see our page on itchy skin in menopause.

What can help with menopause vaginal itching

Things you can try yourself

These come from the Northern Devon leaflet and the British Association of Dermatologists.

Swap soap for a plain soap substitute. Keep soap, bubble bath and shower gel away from the area.
Choose fragrance-free everything. Avoid scented products and wet wipes.
Change your washing. Use a non-biological washing powder and skip fabric conditioner.
Wear cotton underwear without dye. Avoid tight trousers and tights when you can, and tight clothes at night.
Go without panty liners if possible. If you need one, choose fragrance-free.
Use a plain barrier ointment, such as petroleum jelly, as often as you need.
Dry carefully after you pee.
Clip rather than shave or wax.
Try not to scratch.

A safety note from the dermatologists: emollients and ointments can soak into fabric and make it catch fire more easily. Keep them away from flames and cigarettes, and wash bedding and clothing often.

Treatments to talk to your GP or pharmacist about

What helps depends on the cause, so it's worth finding out what it is first.

Vaginal oestrogen. If thin, dry skin is the cause, this low-dose treatment goes inside the vagina. Women's Health Concern says it can greatly help discomfort, and help put the vagina's natural acid balance and bacteria back on track. Because it works locally, it says the risks are minimal. Our vaginal dryness page explains more.
Steroid ointment. For lichen sclerosus or eczema, a doctor may prescribe one. Use it only as your doctor advises.
Thrush treatment, if thrush is confirmed.
A specialist. If the cause isn't clear, your GP can refer you to a skin or vulval clinic.

When to see a GP about vaginal itching

See your GP if:

the itching keeps coming back or won't go away
you think you have thrush for the first time, you're over 60, or treatment hasn't worked
you notice any of the skin changes in the box near the top of this page
it stings when you pee or you need to go more often. The NHS says you may get more urine infections around menopause. See urine infections in menopause
sex has become painful. See painful sex after menopause

It can feel awkward to bring up. The NHS says GPs are used to talking about these things. You can ask for a woman doctor, bring someone with you, and ask the doctor to stop an examination at any time.

Vaginal itching often goes with vaginal dryness in menopause and menopause discharge. You can see them all in our list of perimenopause symptoms.

This page is general information, not medical advice. If you're worried about any symptom, please talk to your GP or pharmacist.

See all perimenopause symptoms

Menopause vaginal itching: why it happens, when it's thrush, and what helps