Thought this might help. The term VA can confuse women because they think it's all about vaginas when in fact it's about vagina, bladder, pelvic floor etc.
This is from the website Patient
Atrophic vaginitis is very common in postmenopausal women, due to the falling levels of oestrogen. The term genitourinary syndrome of menopause (GSM) is now usually used instead of vulvovaginal atrophy or atrophic vaginitis[1].
During the reproductive years, the vaginal epithelium thickens under the influence of oestrogen and produces glycogen. As they die, the glycogen-rich cells provide food for Döderlein's bacilli, which in turn produce lactic acid, maintaining an acidic vaginal environment. After the menopause, oestrogen levels fall and this produces changes in the vagina:
The vaginal mucosa becomes thinner, drier, less elastic and more fragile. It may become inflamed.
The vaginal epithelium may become inflamed, contributing to urinary symptoms (see under 'Presentation', below).
Changes in vaginal pH and vaginal flora may predispose to urinary tract infection (UTI) or vaginal infections.
Reduced oestrogen levels may affect periurethral tissues and contribute to pelvic laxity and stress incontinence.