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Dr. Kelly Casperson's Substack
The Difference Between "Senile Vagina" and "Vaginal Atrophy"

The Difference Between "Senile Vagina" and "Vaginal Atrophy"

A Lesson in Medical Bias and Progress

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Kelly Casperson, MD
May 14, 2025
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Dr. Kelly Casperson's Substack
Dr. Kelly Casperson's Substack
The Difference Between "Senile Vagina" and "Vaginal Atrophy"
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Medicine has a long history of not only misunderstanding women's health but actively shaming it. One of the most egregious examples is the term "senile vagina." Yes, that was a real medical diagnosis - and not eons ago - the 1980s. The very phrase drips with condescension, a linguistic relic from a time when women's aging bodies were seen as problems and inferior rather than deserving of care. Thankfully, medical terminology has evolved, though not without its missteps. Let's break down the difference between "senile vagina," "vaginal atrophy," and where we stand today with the more encompassing term: Genitourinary Syndrome of Menopause (GSM).

From "Senile Vagina" to "Vaginal Atrophy"

Both "senile vagina" and "vaginal atrophy" describe the thinning, drying, and inflammation of vaginal tissues due to estrogen loss. But while they address the same physiological condition, the language surrounding them tells a much bigger story about how medicine has historically framed women's aging bodies

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"Senile Vagina": A Case Study in Medical Gaslighting

Coined in the mid-20th century, "senile vagina" reflected a damaging and reductive view of postmenopausal women. It wasn't just a descriptor—it was a value judgment. The term directly linked vaginal changes to "senility," as if a woman's reproductive system and cognitive function were inevitably deteriorating in tandem. It's no wonder this language was both offensive and dismissive, reinforcing the idea that postmenopausal women were past their usefulness and unworthy of medical attention. The Google definition of senile: “(of a person) having or showing the weaknesses or diseases of old age, especially a loss of mental faculties”. Yikes.

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