Vulvovaginal atrophy (VVA) or atrophic vaginitis is a medical challenge because it is under-reported by women, under-recognized by health-care providers and, therefore, under-treated. More or less 50% of postmenopausal women experience vaginal discomfort attributable to VVA. Very recent surveys suggest health-care providers should be proactive in order to help their patients to disclose the symptoms related to VVA and to seek adequate treatment when vaginal discomfort is clinically relevant. Women are poorly aware that VVA is a chronic condition with a significant impact on sexual health and quality of life and that effective and safe treatments may be available. Indeed, female sexual dysfunction and genitourinary conditions are more prevalent in women with VVA. That being so, it is very important to include VVA in the menopause agenda, by encouraging an open and sensible conversation on the topic of intimacy and performing a gynecological pelvic examination, if indicated. According to very recent guidelines for the appropriate management of VVA in clinical practice, it is essential to overcome the vaginal 'taboo' in order to optimize elderly women's health care.