Risk factors

Certain factors may contribute to GSM, such as:

• Smoking. Cigarette smoking affects your blood circulation, and may lessen the flow of blood and oxygen to the vagina and other nearby areas. Smoking also reduces the effects of naturally occurring estrogens in your body.
• No vaginal births. Researchers have observed that women who have never given birth vaginally are more likely to develop GSM symptoms than women who have had vaginal deliveries.
• No sexual activity. Sexual activity, with or without a partner, increases blood flow and makes your vaginal tissues more elastic.