As women age, the body undergoes a variety of natural changes—some expected, others less discussed. One area that deserves more open conversation is how the vagina and overall vaginal health change after the age of 60. While these shifts are completely normal and part of the aging process, many women may not be fully aware of them. This article explores those lesser-known changes, aiming to inform, support, and normalize the conversation around mature women’s health.
After menopause, which typically occurs between the ages of 45 and 55, estrogen levels significantly decline. This drop in estrogen leads to a condition known as genitourinary syndrome of menopause (GSM), which includes various changes in the vagina, vulva, and urinary tract. One of the most common and often surprising effects is vaginal dryness. With less estrogen, the vaginal walls become thinner, less elastic, and produce less natural lubrication. This can lead to discomfort during intercourse, a greater risk of microtears, and increased susceptibility to infections.
Another lesser-known change is the shift in vaginal pH. A healthy premenopausal vagina typically has a slightly acidic pH that helps protect against infections. After 60, the pH level often becomes more alkaline, making it easier for bacteria and yeast to grow. This can lead to more frequent urinary tract infections (UTIs) or yeast infections, even in women who never experienced them before.
The tissue around the vulva may also change in texture and appearance. Some women may notice a flattening of the labia or a decrease in pubic hair. These are purely cosmetic changes, but they can affect body image and confidence. Additionally, the muscles of the pelvic floor—which support the bladder, uterus, and vagina—may weaken with age, potentially contributing to urinary incontinence or a feeling of vaginal looseness.
What often goes unmentioned is how these physical changes can influence a woman’s sense of self, intimacy, and emotional well-being. Many women feel confused, embarrassed, or alone in their experiences—especially since vaginal health is still treated as a taboo subject in some communities. The good news is that many of these changes can be managed or improved. Vaginal moisturizers and lubricants can help with dryness, while topical estrogen therapy (available by prescription) can rejuvenate tissue health and reduce discomfort. Pelvic floor exercises or physical therapy can strengthen internal muscles, improving both comfort and function.
This article not only outlines these important biological shifts but also encourages open dialogue and proactive care. Understanding what’s happening can empower women to seek support, ask questions, and explore treatments that improve quality of life. Aging is a journey, not a decline—and vaginal health deserves just as much care and attention as any other aspect of wellness. Whether you’re experiencing these changes firsthand or supporting a loved one who is, it’s time to break the silence and approach the topic with honesty, dignity, and compassion.
Let’s talk about it. Let’s normalize it. And let’s make sure women over 60 feel informed, supported, and heard.
