Fifty Shades Of The Graying Vagina

Love it or hate it, the “Fifty Shades of Grey” trilogy got women to be more vocal about sex and sexuality. Come on—raise your hand if you own a vibrator! Ask any gynecologist and we’ll tell you that women are finally talking—really talking— about their sex lives.

Vaginas and other parts “down there” may be out of sight, out of mind, but it’s important to start the conversation about how they mature and age. Don’t worry—your vagina won’t actually turn gray.

Much like the face, the vagina and its external counterpart, the vulva, actually go through the same age-related changes—loss of fat, sagging, discoloration, and even some wrinkles. Until women started shaving, waxing, and stripping, they were largely oblivious to the changes taking place in that dense thicket of hair. Major changes begin to occur in the vaginal area at the start of menopause. Along with hot flashes and night sweats, women complain about dryness and painful intercourse that increases over time, which can lead to lack of sexual drive and pleasure. Even the size of the vagina decreases over time, contributing to painful intercourse. Discoloration may also occur, making the vulva darker and the vagina more smooth and pale.

Decreasing hormone levels are the culprit. Decreasing hormone levels contribute to loss of muscle tone, blood flow, and collagen, as well as the thinning of the external skin and mucosa. It makes it difficult for the external skin and vaginal mucosa to retain water. The external labia, once revered as the “Lotus Flower,” now starts to whither. Overall lubrication decreases, especially during intercourse, and dryness and itching occur. Women typically feel uncomfortable during intercourse and sometimes in their clothing due to the skin laxity.

You must be thinking “please, stop! This is too much information!”

There are ways to combat some of these aspects of aging. Pharmaceutical companies were the first responders to the maturing vagina and have created estrogen-based vagina creams to improve some of the symptoms mentioned. However, given the possible link between estrogen and breast cancer as well as a mass of cream inside your vagina, this option starts to seem less attractive. Oral forms of estrogen can be helpful, but do not likely reach the vaginal tissue as much. Not every woman is a candidate for hormone replacement therapy, so it’s best to consult your doctor.

There are several over-the-counter remedies such as pH balancing gels and probiotics that will help the vagina maintain an environment we consider “normal.” While these products may relieve symptoms, they will not stop age-related changes from progressing. Even the newest pharmaceutical, non-hormonal concoction has limited potential.

To slow vaginal aging, we’ve learned to apply the same technology used on the face and body to the intimate area. The sources used to tighten our face, improve tissue texture and lubrication, and increase collagen formation are now being used to aesthetically enhance the appearance of the vulva and improve the integrity of the mucosal lining of the vagina. This also enhances lubrication and sexual satisfaction—a breakthrough for the complicated puzzle of female sexuality. This is literally “bringing sex back” to women and their relationships, which is enhancing the second act of their lives and improving relationships!

Special thanks to Cindy Wolf for contributing to this piece.

Dr. Susan G. Murrmann is a co-founder of the McDonald Murrmann Women’s Clinic, celebrating its 20th anniversary this month, and co-founder and medical director of the McDonald Murrmann Center for Skin, Laser and Healthy Aging. She lectures locally and internationally on a variety of women’s health topics, and she is considered an expert on bio-identical hormone replacement, menopause management, female “rejuvenation”, and healthy lifestyle choices. Dr. Murrmann focuses on educating her patients about healthy aging by stressing that it is multifaceted and encompasses all areas of a women’s lives….even those parts that her patients don’t want to discuss! For more information call McDonald Murrmann Women’s Clinic 901.752.4500 or visit their website

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