Some women experience it immediately after childbirth.
For menopausal and post-menopausal women in particular, regular sexual activity, with or without a partner, is recommended. Sexual activity improves blood circulation in the vagina , which helps maintain the tissue. A pelvic examination reveals thin, pale vaginal walls. Hormonal studies may be done if menopausal status is uncertain. Topical estrogen creams may be used vaginally or oral estrogen replacement therapy may be initiated.