Many women enter menopause prepared for hot flashes and mood swings. But few are prepared for a much more intimate, and often distressing, change: the shrinking or disappearance of the labia minora. It’s rarely discussed—either in doctor’s offices or among friends—but for many menopausal women, it’s a surprising and even shocking discovery. If you’ve looked down and wondered, “Where did they go?”, you’re not imagining things—and you’re not the only one.
What Is the Labia Minora?
The labia minora are the thin inner folds of skin that sit just inside the outer lips of the vulva (the labia majora). These delicate structures help protect the vaginal opening, contribute to sexual sensation, and play a role in the production of natural lubrication. But with the onset of menopause and the decline of estrogen, the labia minora—like many parts of the vulva and vagina—undergo significant changes.
Why Do the Labia Minora Shrink or Disappear?
The primary reason behind the reduction or loss of labia minora during menopause is estrogen deficiency. Estrogen is a key hormone in maintaining the elasticity, thickness, and moisture of vaginal and vulvar tissues. As estrogen levels fall during perimenopause and menopause, these tissues begin to thin, dry out, and lose their structural integrity.
This condition is part of a broader syndrome known as Genitourinary Syndrome of Menopause (GSM), which encompasses a range of physical and functional changes in the vulva, vagina, urethra, and bladder due to hormonal shifts.
What Happens to the Labia Minora Specifically?
Tissue Atrophy: The labia minora may lose volume and shrink. In some cases, they may almost completely flatten or recede, making them seem as though they’ve disappeared.
Loss of Color and Texture: With reduced blood flow and thinning of the skin, the labia may become paler and smoother, further adding to the perception of loss.
Fusion or Adhesion: In some cases, the labia minora may begin to stick together or adhere to nearby skin, especially in women who are not sexually active or who experience chronic dryness.
This process isn’t harmful in and of itself, but it can be distressing, affect self-esteem, and lead to discomfort during intimacy or while wearing certain clothing.
Other Vaginal and Vulvar Changes During Menopause
The loss of labial tissue is just one of many changes that can affect your genitals during menopause. Here’s what else can happen:
Vaginal Dryness: One of the most common complaints. Without estrogen, the vaginal walls produce less natural lubrication.
Loss of Elasticity: The vaginal canal and vulva can lose their stretchiness, making intercourse uncomfortable or even painful.
Thinning Skin: Vaginal and vulvar tissues become fragile and more prone to microtears, irritation, and infections.
Changes in pH: The vagina becomes more alkaline, which increases the risk of infections like bacterial vaginosis or UTIs.
Decrease in Pubic Hair: Hormonal changes can lead to thinning or loss of pubic hair, which can also affect how the area looks and feels.
Clitoral Atrophy: The clitoris, like the labia, may shrink and become less sensitive over time.
Changes in Odor or Discharge: A different balance of bacteria and changes in pH can lead to altered discharge or a new vaginal odor.
What Can You Do About These Changes?
While these changes are natural, they are not inevitable or untreatable. There are effective ways to preserve vulvovaginal health and even restore tissue integrity and comfort.
Topical Estrogen Therapy
Localized estrogen creams, tablets, or rings can rejuvenate the tissue without the risks associated with systemic hormone therapy. These treatments often dramatically improve lubrication, elasticity, and overall tissue health.
Vaginal Moisturizers and Lubricants
Non-hormonal products designed to retain moisture (like hyaluronic acid gels or vitamin E suppositories) can ease dryness and irritation. Lubricants should always be used during sex to avoid microtears.
DHEA Suppositories
Prasterone (a form of DHEA) is a hormone-based vaginal suppository approved for use in postmenopausal women to treat painful intercourse and improve tissue quality.
Laser and Radiofrequency Therapy
Procedures like MonaLisa Touch or ThermiVa use energy to stimulate collagen production and tissue regeneration in the vaginal area, though access and affordability vary.
Gentle Vulvar Care
Avoid soaps, douches, and perfumed products on the vulva. Stick to plain water or mild, unscented cleansers.
Regular Sexual Activity or Vaginal Use
Whether through intercourse or use of vaginal dilators, regular stimulation helps maintain blood flow and tissue flexibility.
When to Talk to a Healthcare Provider
If you’re experiencing discomfort, dryness, recurrent infections, or notice physical changes to your vulva or vagina that worry you, don’t hesitate to consult your gynecologist or menopause specialist. These conversations might feel awkward—but they are crucial. Healthcare providers are increasingly aware of GSM and the importance of vulvar health in midlife and beyond.
Breaking the Silence
The disappearance of the labia minora during menopause is a real and common experience. Yet because of shame, stigma, or lack of awareness, many women suffer in silence. By talking openly about these changes—and seeking support—we can shift the narrative and empower women to take charge of their intimate health.
Understanding what’s normal, what’s common, and what’s treatable is the first step toward reclaiming comfort, confidence, and connection with your body.
Symptom Relief
Managing menopause symptoms can feel overwhelming, especially when effective solutions seem hard to find. From unexpected skin changes to frustrating hot flashes, these shifts can impact daily life and overall well-being. Explore our Symptom Relief page to discover products that other women have found helpful in managing their symptoms of perimenopause and menopause.
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Explore More
Want to dive deeper into menopause and its symptoms? Visit our Resources page, where you’ll find a collection of studies, articles, and books from trusted experts. Whether you're looking for the latest research or practical insights, these resources can help you better understand your body and make informed decisions about your menopause journey.
