Hot flashes means that vaginal atrophy has already begun. The symptoms that most women talk about, vaginal dryness, difficulty having sex and loss of libido are frequently attributed to yeast infections or temporary painful intercourse. In fact, these are the symptoms of vaginal atrophy which start off as subtle changes that gradually appear over time. Vaginal atrophy is progressive and the end result in the senior years is thin vaginal tissues that become prone to infections which impact overall health. Keeping a healthy vagina should be the priority of a menopause plan because vaginal atrophy is perhaps the most deleterious and longest lasting effect of menopause. Hot flashes, sleeplessness etc. are all serious things to experience but they are easiy treated by a range of medications depending on a woman's preference. The silent menace of menopause is that a woman's vagina begins to self-destruct as estrogen levels decrease and left untreated leads to progressively declining vaginal health.