Vaginal Dryness

Vaginal dryness happens when the tissues in your vagina are dry, thin and not well-moisturized. This leads to discomfort, especially during sex. It can cause pain while sitting, exercising and peeing, too.

Vaginal dryness can occur at any age. More than 15% of females have it before menopause. Over half experience vaginal dryness after menopause.

It’s most common during this period of life because your estrogen levels decline. Estrogen helps keep your vaginal lining moisturized and healthy. Low levels of this hormone cause your vaginal walls to become thin and dry. This is a common condition of menopause called vaginal atrophy.

You don’t have to live in discomfort. Many safe and effective treatments are available for vaginal dryness. Ask your healthcare provider for guidance. They want to help you feel your best.

What does a dry vagina feel like?

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

• Burning and itching
• Bleeding after sex due to your vaginal wall tissues breaking open
• Soreness in your vulva (genitals)
• Frequent urinary tract infections (UTIs) or yeast infections
• Needing to pee more often

Less moisture in your vagina leads to less moisture in your vulva. So, you may feel dryness or irritation when putting on your underwear or during activities like walking or sitting.

What are the most common causes of this symptom?

In many cases, vaginal dryness happens when estrogen levels decrease. This occurs naturally as you age or during menopause. Other things that can lower estrogen levels include:

• Anti-estrogen medications for uterine fibroids or endometriosis
• Breastfeeding
• Birth control pills or any form of hormonal birth control
• Cancer treatments, like chemotherapy and hormone therapy
• Certain antidepressants
• Removal of your ovaries
• Smoking

Other conditions or situations that may cause vaginal dryness or increase your risk of it include:

• Diabetes
• Lichen planus that affects your vulva or vagina
• Lupus
• Sjogren’s syndrome
• Consuming alcohol
• Stress
• Not being sexually aroused
• Using scented or perfumed soaps, sprays and washes around or in your vagina

How is this symptom treated?

Many treatments can help vaginal dryness and the painful sex associated with it. If you just have vaginal dryness, you may want to first try over-the-counter (OTC) moisturizers and lubricants:

• Vaginal moisturizers: Apply 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 sex. Healthcare providers mainly recommend water-based vaginal lubricants. But there are also silicone-based products.

Don’t use products that aren’t meant for your vagina (like face and body lotion).

If you have vaginal dryness with other menopause symptoms, medical treatments may be a better option. Most of these treatments work by either replacing or acting like estrogen in your body. They’re prescription-only. Medical treatments include:

• Low-dose estrogen creams, rings or tablets: You apply creams and tablets directly into your vagina. You typically use them daily until you find relief, then weekly as needed. You put a ring into your vagina for up to three months, then replace it.
• Ospemifene: This medication is a selective estrogen receptor modulator (SERM). You take it by mouth. It treats painful sex associated with vaginal atrophy.
• Dehydroepiandrosterone (DHEA): This is another medication that acts like estrogen. It’s a vaginal suppository that helps with painful sex when you’re in menopause.
• Laser therapy (MonaLisa Touch®): This therapy helps the tissues in your vagina regenerate, helping it to become moist again.

Talk to your healthcare provider about the risks and benefits of these treatments.

What are the possible complications or risks of not treating it?

Vaginal dryness isn’t dangerous. But it can greatly affect your quality of life. Without treatment, it can lead to:

• Daily discomfort
• Painful sex
• Relationship stress
• Depression or anxiety

Can this symptom be prevented?

It’s not always possible to prevent vaginal dryness. But you can take certain actions to help improve it, like:

• Avoiding scented products and douching
• Using gentle soaps around your vulva
• Wearing cotton underwear
• Drinking water to stay hydrated
• Having regular sexual stimulation to encourage your vaginal tissues to become moist
• Trying a longer period of foreplay before sex to help with arousal

When should this symptom be treated by a healthcare provider?

You may feel embarrassed to talk to your healthcare provider about vaginal dryness. But many treatments can provide relief. Contact your provider if vaginal dryness:

• Affects your daily activities
• Affects your sex life or relationship with your partner(s)
• Doesn’t get better with over-the-counter treatments
• Happens alongside severe vaginal bleeding