Vaginal Dryness

What is vaginal dryness?

Vaginal dryness is a painful symptom that affects your quality of life. It can cause pain during sitting, exercising, peeing and sexual intercourse. Normally, your vaginal lining is lubricated with fluid that helps keep it thick and elastic. Vaginal dryness happens when the tissues in your vagina are dry, thin and not well-moisturized. This leads to discomfort, especially during sex.

Vaginal dryness occurs at any age. It’s most common during or after menopause when estrogen levels decline. The hormone estrogen helps keep your vaginal lining moisturized and healthy. Low levels of estrogen cause your vaginal walls to become thin and dry. This is a common condition of menopause called vaginal atrophy.

Many safe and effective treatments are available for vaginal dryness.

Is vaginal dryness common?

Around 17% of women age 18 to 50 report problems with vaginal dryness during sex, even before menopause takes place. Over half experience vaginal dryness after menopause.

What are the possible causes of vaginal dryness?

In many cases, vaginal dryness happens when estrogen levels decrease. This occurs naturally as you age or during menopause. Menopause is when your menstrual period ends and you can no longer become pregnant. When estrogen levels decline, the skin and tissues of your vulva and vagina become thinner and less elastic, and your vagina can become dry.

Certain health conditions or treatments for health conditions and can also cause vaginal dryness. Vaginal dryness can result from:

• Breastfeeding and childbirth.
• Birth control pills or any form of hormonal birth control.
• Cancer treatments including chemotherapy and hormone therapy.
• Diabetes.
• Medications, including anti-estrogen medications (treating uterine fibroids or endometriosis), certain antidepressants and antihistamines (treatment for itchy eyes and runny noses).
• Removal of your ovaries (oophorectomy).
• Sjogren’s syndrome (an autoimmune disorder that can cause dryness throughout your body).
• Not being sexually aroused.
• Using scented or perfumed soaps, sprays and washes around or in your vagina.

Why is my vagina dry during sex?

Vaginal dryness is usually most apparent during sexual penetration. Without enough vaginal lubrication, the friction (or rubbing) during sexual intercourse can cause pain and discomfort. Take time before sex to make sure you’re fully aroused. Engage in foreplay with your partner and try to relax. Using water-based sexual lubricants can also help. Unfortunately, painful sex can lead to loss of interest in sex or loss of intimacy with your partner. As embarrassing as it may feel, discuss your symptom with your partner so they can help you.

What does a dry vagina feel like?

Vaginal dryness causes discomfort and pain in your vagina, especially during sex. A dry vagina may also cause:

• Burning and itching.
• Bleeding after sex due to your vaginal wall tissues breaking open.
• Soreness in your vulva.
• Recurrent urinary tract infections (UTIs) or yeast infections.
• Needing to pee more often.
• Not wanting to have sex.

Less moisture in your vagina leads to less moisture in your vulvar area (external genitals). This means you can feel dryness or irritation when putting on your underwear or during normal activities like walking or sitting.

How is vaginal dryness diagnosed?

Healthcare providers diagnose vaginal dryness based on your medical history and a physical exam. To find the cause, your provider will ask about your symptoms and any medications you take. They may perform the following tests:

• Pelvic exam to view the inside of your vagina, which may be thin, dry and red.
• Blood test to determine if hormone levels or a health condition are causing vaginal dryness.

Your provider may also test a sample of your vaginal discharge to rule out other causes or to check for signs of infection.

How is vaginal dryness treated?

There are many treatments available for vaginal dryness and painful intercourse (dyspareunia) associated with vaginal dryness.

Medications for vaginal dryness

Medications work by either replacing or acting like estrogen in your body. They’re available with a prescription only.

• Low-dose estrogen cream, ring or tablet: These medications work by replacing estrogen in your body. Creams and tablets are applied directly into your vagina using an applicator. Most are prescribed for daily use until you find relief, then used weekly as needed. Estrogen-containing rings are placed into your vagina for up to three months, then replaced.
• Ospemifene (Osphena): This medication is called a selective estrogen modulator (SERM) and is taken by mouth. It acts like estrogen in your body and helps treat painful sex associated with vaginal atrophy.
• Dehydroepiandrosterone (DHEA): This is another medication that acts like estrogen in your body. It’s a vaginal suppository that helps with painful sex when you're menopausal.

Talk to your healthcare provider about the risks and benefits of medication containing estrogen or estrogen-like substances. Estrogen may not be safe for you if you've had breast cancer or are at high risk of breast cancer.

Lubricants and moisturizers for vaginal dryness

Lubricants and moisturizers are available without a prescription and can be purchased at drug or grocery stores. They work by replenishing your vaginal tissue and making it wet, which can help with pain during sex. You shouldn’t use moisturizers (such as for your face or body) that aren’t meant for your vagina.

• Vaginal moisturizers: Apply vaginal moisturizers to the inside of your vagina every few days to keep your vaginal lining healthy. Some examples include Replens™, Luvena® and KY® Liquibeads.
• Vaginal lubricants: Apply lubricants just before sexual intercourse to ease discomfort caused by sex. Astroglide® and KY® Jelly are examples of water-based vaginal lubricants. There are also silicone-based and oil-based lubricants.

What foods increase female lubrication?

There isn’t much research about specific foods you should eat to increase vaginal lubrication. Drinking water and staying well-hydrated helps your body retain its moisture.

How do you treat a dry vagina naturally?

Natural oils such as grape seed, olive, vegetable, sunflower or coconut oils may be a safe home remedy for vaginal dryness. Natural oils should be used as an external lubricant before intercourse. However, oil-based lubricants can damage condoms, so if you are of childbearing age, use only water-based lubricants.

Some providers recommend regular sexual stimulation to help encourage your vaginal tissues to become moist. Another thing to try is a longer period of foreplay before intercourse. Vaginal moisture is tied to arousal. Look for ways you and your partner can increase your pleasure before intercourse.

When should I call my healthcare provider?

A dry vagina is usually not a sign of a serious medical condition, but you may feel embarrassed to talk to your healthcare provider about it. But many treatment options are available for this common symptom. Contact your provider if vaginal dryness:

• Interferes with your daily activities.
• Affects your sex life or relationship with your partner.
• Doesn’t get better with over-the-counter treatments.
• Is accompanied by severe vaginal bleeding.