Low levels of estrogen cause the vaginal tissues to become less lubricated. The vagina receives less blood supply and nutrients, and thins out. The vagina is less acidic, and the bacteria normally present in the vagina are replaced by other, harmful bacteria. The vagina becomes more prone to trauma and infection. Most women have no symptoms.
Atrophic vaginitis occurs when the ovaries produce too little estrogen.
It is very rare in children. Girls who do have it may have spotting and vaginal discharge. Breastfeeding mothers often report vaginal dryness and painful intercourse. After menopause, as the ovaries produce less estrogen, the vagina becomes thinner. Bacterial overgrowth and trauma during intercourse become more likely.