Vulvovaginal atrophy (VVA), a condition associated with declining estrogen levels, is commonly seen in postmenopausal women. VVA is marked by vaginal dryness, itching, dyspareunia and incontinence, which can contribute to diminishing quality of life for millions of postmenopausal women worldwide. Most available treatments contain estrogen, whether administered locally or systemically. Other treatment options include lubricants and moisturizers. These therapeutic approaches can provide temporary relief of some VVA symptoms while on therapy, but do not address the underlying condition, and they are not without potential side effects. However, promising new VVA therapies are in development that target the underlying condition with acceptable side-effect profiles. In this article, the benefits and drawbacks of current therapies and new treatments under development for VVA are discussed.