Before menopause, high levels of estrogen stimulate maturation of the vaginal lining to generate a thick layer of mature superficial cells. After menopause, a lack of estrogen leaves the vaginal lining much thinner, with very few or no superficial cells. In many women, this thinning is associated with vaginal dryness, irritation, itching and pain with intercourse, a condition referred to as vaginal atrophy or atrophic vaginitis.
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