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After the menopause, many women experience a thinning and drying of the vaginal walls due to a reduction in the production of oestrogen. This vaginal dryness is also referred to as vaginal atrophy or medically as atrophic vaginitis. Vaginal dryness, where the vagina is less able to produce a natural lubricant, can lead to painful sexual intercourse, including bleeding, which often results in an avoidance of penstrative sex. Vaginal atrophy can also cause continence issues. Symptoms to look for include vaginal itching or burning as a direct result of the dryness. The inner and outer lips or labia of the vagina may also shrink in size or become more dry and pale in appearance.