How to Relieve Vaginal Dryness, Atrophy & Painful Sex-Related BV?

When do women experience dryness and painful sex?

The female reproductive hormone estrogen supports the development and wellbeing of the woman’s reproductive tissues, including the vagina. A healthy reproductive-aged woman has a high level of estrogen. Her vaginal lining is thick and well moisturized (1).

The estrogen level in a woman gradually declines with aging after menopause.

However, after a woman reaches menopause, the production of estrogen declines (2). Her vaginal tissue shrinks, becoming dry and increasingly atrophied with aging. The dried and atrophied tissue is frequently infected by bacteria or yeast and shows inflammation. Therefore, vaginal atrophy, also called atrophic vaginitis, occurs and major symptoms are dryness and painful sex or dyspareunia.

In addition to menopause, certain health conditions may also cause vaginal atrophy, dryness, and painful sex at a younger age. These health conditions include:

On birth control pills

Hormonal IUD (Mirena)



• Certain diseases like lichen sclerosuslichen planuslupusSjogren’s syndrome, Celiac disease, and polycystic ovary syndrome (PCOS), that affect vaginal skin or a woman’s hormonal level.

• Cancer therapy, especially breast cancer treatment.

• Side effects of medications like antihypertensives, antidepressants, and antiallergics.

What are the symptoms of vaginal atrophy?

Vaginal atrophy (tissue shrinkage with reduced elasticity) may cause a range of symptoms. These include vaginal dryness, painful intercourse, itching, and burning. It may also cause a foul odor if it coexists with bacterial vaginosis (BV).

Vaginal dryness and painful sex are major signs of vaginal atrophy

What is bacterial vaginosis (BV)?

BV is not a true infection but rather a disruption in the balance of normal bacteria.

BV is also known as nonspecific vaginitis. It results from an overgrowth of bacteria normally present in the vagina, in contrast to infection with foreign bacteria.

Gardnerella is one type of bacteria that have been implicated in the development of BV. Symptoms of BV include vaginal discharge and odor.

Difference between BV in pre-and postmenopausal women (or young women with vaginal atrophy due to certain health conditions)

Before a woman reaches menopause, BV is just BV. However, in a postmenopausal woman or young woman with certain health conditions BV may coexist with vaginal atrophy. Major symptoms of vaginal atrophy are vaginal dryness and painful sex.

The cause of vaginal atrophy is estrogen reduction due to menopause or certain health conditions described above.

When associated with vaginal atrophy, BV may not be easily cleared and often becomes recurrent. The reason is reduced resistance against infection when the vaginal lining is atrophied, dried, and frequently inflamed due to injuries caused by painful intercourse.

To help clear BV in a postmenopausal woman, doctors often prescribe estrogen cream to help regrow the atrophied vaginal lining.

However, many women, especially breast cancer survivors, cannot use estrogen because it has a risk for breast cancer.

Can the vagina protect itself from bacterial infections?

Yes. It can when it is not atrophied.

Before menopause, the high level of estrogen promotes a thick, multiple layered vaginal lining skin.

Left: Multiple layered vaginal lining superficial cells peel off daily to remove attached bacteria. Right: after menopause, only 1 layer of superficial cells remains and surface cell peeling stops and bacteria attached to the skin surface are not removed naturally.

On top of the vaginal lining are multiple layers of superficial cells. The top layer of the superficial cells shed daily to renew its surface. This process is called vaginal cell exfoliation, like dandruff shedding from the scalp. This causes bacteria attached to the lining surface to shed and be flushed out by vaginal discharge regularly.

When vaginal lining cells exfoliate, attached bacteria are removed naturally.

As a result, the second layer of the skin that is free of bacteria becomes a new top layer. Like peeling an onion, after the cells in the damaged old top layer is removed, the renewed top layer is cleaner and free of damages.

Vaginal lining cell exfoliation is like onion peeling.

This regular skin cell exfoliation renews the surface frequently and protects the vagina from bacterial infection or overgrowth.

The protection reduces after menopause or under certain health conditions

After menopause or under certain health conditions, estrogen reduces. As a result, the multiple superficial cell layers of the vaginal lining skin shrink to just a single layer. Cell exfoliation stops, causing bacterial accumulation in the vagina, and making it more susceptible to BV.

BV with vaginal atrophy can be difficult to treat.

When recurrent BV occurs after menopause or under certain health conditions, it may coexist with vaginal atrophy and can be difficult to treat. Antibiotics can temporarily remove bacteria from the vaginal skin surface. However, due to a lack of frequent vaginal skin cell exfoliation, bacteria can come back soon after the antibiotic treatment stops, causing recurrent or chronic BV.

Treatment options for BV in women with painful sex

1. Antibiotics may not work well

When a woman develops recurrent BV and also suffers vaginal atrophy visiting a doctor for treatment, the doctor may prescribe antibiotics. Antibiotics may be effective in clearing the first episode of BV.

After the treatment stops, however, BV often recurs to become recurrent BV (3). The doctor may prescribe antibiotics again, and BV again recurs. Repeated use of antibiotics may cause side effects, such as drug resistance and yeast infection.

2. Vaginal estrogen may be effective but unsafe

The doctor may prescribe an estrogen cream like Premarin in addition to antibiotics. Inserting estrogen cream directly into the vagina can restore hormone levels when used repeatedly for a long term. This helps relieve vaginal atrophy and ultimately clear BV. The reason is that estrogen supports the growth of a thick vaginal lining skin. Thick skin can frequently peel off the surface cells to remove bad bacteria.

Estrogen may be effective, but it may increase the risk of many diseases like cancers including breast, ovarian, and uterine cancers, uterine fibroids, stroke, and heart disease. Therefore, women who have a history or family history of breast cancer, uterine fibroids, stroke, and heart disease should not use estrogen.

Some estrogen products are made from horse urine and may involve animal cruelty. Many animal lovers are against using this type of estrogen.

3. Probiotics may fail to provide relief

In addition to painful sex, another major symptom of vaginal atrophy is dryness. All life forms require water. Lacking water may be the reason that no life is found on Mars. Likewise, probiotics lactobacillus needs water to survive. Applying probiotic lactobacilli into an atrophied vagina is like putting fish in a dried pound. Therefore, probiotics may not work for BV in women with vaginal atrophy. Although it may not cause any harm, it may be a waste of money (4).

4. NeuEve – Safe and effective home remedy

NeuEve products are safe alternatives to estrogen. NeuEve works by nutritional supplements. It provides nutrients, such as vitamins, minerals, and fatty acids, to promote the healing of the atrophied vaginal lining skin. This article explains how NeuEve reverses vaginal atrophy without using hormones.

Topical nourishment by NeuEve can make the vaginal skin to grow thicker. As a result, surface skin cell shedding in the vagina can become more frequent, thereby reducing the attached bacteria and the risk of BV.

NeuEve is a natural product, not a drug. Therefore, a doctor’s prescription is not required. NeuEve can be used as an effective home remedy for self-treatment of vaginal atrophy-related BV.

To date, NeuEve has helped more than 100,000 women with vaginal atrophy and atrophy-related BV to find relief safely and effectively with no reported side effects. Many gynecologists and urologists have been recommending NeuEve.

5. What are the right products to start?

The most effective NeuEve product for relieving vaginal atrophy-related BV is the NeuEve Gold suppository. However, if a woman has a severe type of vaginal atrophy, she may be sensitive to the strong product. We have designed 3 milder products, Silver, Silk, and Cream. You can choose the right product based on your age and severity of vaginal atrophy. If you choose a milder product, you can move up a level gradually. Once you move up to the Silver or Gold level, your BV will be cleared.

These products can make a thinned vaginal lining skin thicker and more resilient, but it takes time. Although some customers reported noticeable relief within 1 day, for a full recovery, it may take several weeks or months depending on how severe your vaginal atrophy is.

Interestingly, many customers with tenacious recurrent BV that did not respond to estrogen and antibiotics have found relief by using NeuEve. For breast cancer survivors who cannot use estrogen, NeuEve has provided an alternative option for them to find relief safely from vaginal atrophy and BV.

The following three articles can help you choose appropriate NeuEve products for clearing your BV and stop recurrent BV from coming back based on your age and health condition.

Is BV after menopause treated differently?

Which formula is right for clearing my BV?

How to stop BV from coming back?


Customer reviews on NeuEve from BV clearance after menopause

“I am a young cancer survivor that was forced into menopause early from my cancer treatments. This is the only product that has worked long term for me.

I struggled with BV issues for some time and obviously vaginal atrophy from pelvic radiation, since using this product I have not had one single reoccurrence of BV. I have since recommended this product to a few of my friends all of whom are either pre-or post-menopausal with similar issues (odd odor, less natural lubrication) and they all seem to love it and recommend it.

I would say initially I was skeptical; I have been using this for about 6 months and my honest opinion is that this product is exactly what the packaging states. Please keep in mind I produce no natural hormones and have been in hormone replacement therapy for 5 years, nothing has worked as well as this product. It is safe, effective, and works quickly.”

“I’d just like to say thank you!!!

I’ve suffered for several years with BV and vaginal dryness. I’ve been prescribed everything under the sun from my physician and have tried many home remedies. Nothing has worked!!!

Also, my physician failed to tell me that BV can be caused by perimenopause and vaginal dryness.

When I stumbled upon your website while looking for yet another home remedy, I read your home page and thought wow, my symptoms are right there!!! So I took a chance and ordered the BV Clear and the Silver. From the time, I used the first suppository, I felt relief!!!! and the odor and itchiness are gone!!!

I have never written a review or emailed anyone about a product but I just had to do this because I am eternally grateful to your company for making such an amazing product!!! My struggles are over!!!!

Again, thank you so very much for taking this problem seriously and making a product that truly works!!!!! There are a lot of women out there suffering the way I have and I will without a doubt recommend your product to any woman!!!!!! This has really changed my life!!!”

“I have had itching and resulting burning from the constant itching, which are symptoms of BV and vaginal atrophy, I also had a horrible darkening of my vagina and painful intercourse. I also have symptoms and signs of Lichen Sclerosus.

I ordered the product to see whether I could get rid of this horrible nightmare of a year and a half of itching. I waited until I completed the 3 suppositories before writing a review so that I could give an honest assessment of how this product worked for me. I completed the full BV Clear, using one suppository every 3-5 days (with a break between for my menses).

On the first night, due to the damage from scratching it burn and was irritated for about a minute or so. On the outside areas that burned, I wiped with an unscented, lint-free wipe. After the sensation subsided I was so overjoyed! The itching minimized and the product felt like it was “working” and I was able to fall asleep without scratching myself raw, my vagina also felt different, as if blood was circulating around the area and plumping it up.

After my menses, I used 2nd suppository. There was no burning and the itching was still progressively getting less and less (this was far better results than the medications that I was prescribed that didn’t do anything but burned constantly with no relief from the burning or itching).

I used the last suppository and there was no burning except in areas where I had irritated (and areas where the LS bumps were). But even in those areas, the bumps were not as pronounced or itchy, or painful as before. After using the 2nd suppository, I realized that my prayers for relief were answered and I immediately ordered another BV Clear AND the NeuEve Assorted Suppository Kit and the NeuEve cream.

My only regret (in my haste to try anything that may have worked for me), I didn’t order the NeuEve vulvar itching Cream in my first order, since I still had itching around my vulvar and believed that may have helped me also to completely stop the constant itching whiles using the suppositories.”

” I am so happy to have found NeuEve. I have been suffering from BV after some long-term antibiotic use. I ordered silver after some research on vaginal atrophy.

I also found that NeuEve has a product BV Clear. These products are a lifesaver!!! After just one use the BV has cleared! My Dr. kept prescribing more antibiotics to treat BV and they never worked. I am so happy to have found NeuEve! I will continue with the silver and gold! “

About the author

Dr. Renjie Chang's medical and pharmaceutical experience:
- OB-GYN in the Peking Union Hospital in China
- a faculty member of OB-GYN at University of Oklahoma Health Sciences Center
- drug developer at the Abbott Laboratories in Chicago
- Founder of Lavax, Inc, where she developed an innovative vaginal microbicide for preventing sexually transmitted disease with grants from NIH and Gates Foundation
- Founder of NeuEve, an all-natural women's health company

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