Vaginal dryness occurs due to a lack of vaginal lubrication (wetness). It can cause symptoms like dryness, irritated skin, burning, or itching.
Vaginal dryness is most common during menopause (when you stop getting your period) and perimenopause (the years leading up to menopause). About 19.4% of people assigned female at birth report vaginal dryness at ages 42-53. About 34% of people aged 57-69 report vaginal dryness.
Vaginal dryness can also result from reproductive surgery, cancer treatment, or other medical conditions. If you’re experiencing vaginal dryness, it’s important to find out the cause to determine the best course of treatment.
While vaginal dryness can be chronic for some people, effective treatment options are available to ease symptoms and provide relief.
Vaginal dryness is a drop in lubrication, or wetness, in your vaginal canal and surrounding areas.
Before menopause, menstruating people produce between one-half to 1 teaspoon of discharge each day. It’s also normal for the vagina to experience varying levels of wetness throughout the month during menstruation. For instance, during ovulation (when you release an egg), you may experience a spike in vaginal lubrication.
You may be experiencing vaginal dryness if:
- Your overall vaginal moisture levels are low for several weeks in a row
- Your vagina seems less lubricated than usual
- Your vulva (outside area of your vagina) is dryer than usual
- You have feelings of irritation, burning, and itchiness in and around your vagina
- You have pain during sexual intercourse or other sexual activity
Pain from vaginal dryness can cause significant feelings of distress around sex. Vaginal dryness is also associated with a lower-than-normal sex drive and a decrease in sexual satisfaction.
Although menopause and perimenopause are the most common and well-known causes of vaginal dryness, vaginal dryness can occur at other points of life and due to other circumstances.
Vaginal dryness usually occurs due to a drop in estrogen, the hormone mainly responsible for keeping your vagina lubricated. Estrogen also maintains the thickness and flexibility of your vaginal tissues.
Perimenopause and Menopause
Perimenopause refers to the years leading up to menopause, and menopause is when you haven’t had a period for at least a year. During this time, your levels of estrogen drop significantly, leading to some amount of vaginal dryness for most people. The vagina also experiences some amount of atrophy, which includes shrinkage and thinning of the vaginal walls.
Medical Conditions Causing Low Estrogen
Anytime you are experiencing a condition or circumstance linked to low estrogen, you may experience vaginal dryness. For example, vaginal dryness can occur:
- In the weeks after childbirth, when estrogen levels are low
- During breastfeeding, because the hormones of breastfeeding can suppress estrogen
- After surgical removal of your ovaries, since the ovaries produce most of your body’s estrogen
- If you have Sjögren syndrome, an autoimmune condition which can cause dryness in your mouth, eyes, and vagina
Medications Side Effects
Sometimes, a medication you’re taking can affect your hormones or your body’s lubrication or moisture levels. Examples include:
- Cold and allergy medication, which can cause overall dryness in your body’s tissues and decrease vaginal lubrication
- Some antidepressants
- Radiation and chemotherapy of the pelvic area
- Injection birth control like Provera and Depo-Provera (medroxyprogesterone)
- Lupron (leuprolide), a medication for endometriosis and fibroids; can decrease estrogen, causing vaginal dryness
- Synarel (nafarelin), a nasal spray used to treat endometriosis
Vaginal dryness isn’t a major problem for some people. However, when vaginal dryness causes uncomfortable symptoms like burning, itching, or painful sex, you should visit your healthcare provider. There are treatments that can ease your symptoms.
If you are experiencing vaginal dryness along with other symptoms that may signal an infection or underlying condition, it’s important to visit your healthcare provider right away for treatment. Possible symptoms include:
- Vaginal discharge that’s gray, green, or yellow
- Discharge that looks chunky, like cottage cheese
- Discharge that has an unpleasant odor
- Burning or irritation when you pee
There are several effective treatments for easing the symptoms of vaginal dryness. It’s best to discuss these with a healthcare provider, who can also diagnose the cause of your vaginal dryness. Your provider can tailor your treatments to your specific situation.
Vaginal Lubricants
Vaginal lubricants are available over-the-counter (OTC) and are used to lubricate (wet) the vagina, usually for intercourse or sexual activity. These generally don’t cause side effects unless you are allergic or sensitive to an ingredient in the lubricant. It’s best to use a lubricant specifically made for vaginas.
Vaginal lubricants may contain oil, silicone, or water. Oil-based products are usually not recommended because they can damage condoms or diaphragms, making them less effective at preventing pregnancy or keeping you safe from STDs.
Vaginal Moisturizers
Vaginal moisturizers typically contain hyaluronic acid. Their purpose is to help your vaginal tissues preserve moisture. The moisturizer is often inserted into the vagina about three times daily, but some products can be used once every few days.
When used regularly, vaginal moisturizers help your vagina stay continually moisturized or wet. Vaginal moisturizers are available OTC, but it can be helpful to discuss options with a healthcare provider.
Hormonal Options
There are several hormonal options available to treat vaginal dryness. Your healthcare provider can prescribe these treatments. Options include vaginal estrogen creams, capsules, rings, or tablets. It can take several weeks for these to work fully.
Although these options contain hormones, they are absorbed in much smaller doses than in other forms of hormone therapy.
Nonhormonal Prescription Options
There are two nonhormonal medications available to help treat vaginal dryness. Osphena (ospemifene) is a medication taken by mouth that is similar to estrogen—but not the same. It can mimic estrogen’s role in the body, improving vaginal lubrication.
Intrarosa (prasterone), also known as DHEA, is a vaginal suppository inserted into the vagina daily to add lubrication.
Home Remedies
Some people choose to use natural lubricants, like olive, coconut, or avocado oils, to lubricate their vagina. You shouldn’t use these without speaking to your healthcare provider first. Oils like these also make condoms and diaphragms less effective.
Vitamins and probiotics are sometimes recommended for vaginal dryness, but there isn’t strong evidence of their effectiveness. Some people report that adding more soy to their diet or using products containing wild yam help with vaginal dryness. There is also no strong evidence supporting these remedies.
Other Treatments
Alternative treatments for vaginal dryness may be available, such as vaginal laser treatments or other similar options. However, there isn’t good research on the effectiveness of treatments like these, and they aren’t usually covered by health insurance.
Menopause is the most common cause of vaginal dryness, and it can’t be prevented. However, you can avoid some causes, such as medication, and take steps to prevent the worst symptoms:
- Stop or switch medications causing vaginal dryness: If the medication is optional, such as a cold medication, stopping the medication may be helpful. If the medication is important for your health, talk to your healthcare provider about switching to an alternative medication. For example, if you experience vaginal dryness after using a birth control shot, trying a different form of birth control may improve dryness.
- Use a vaginal moisturizer. You can use a vaginal moisturizer daily or throughout the day to prevent symptoms of vaginal dryness.
- Take hormonal treatments. These can help keep the vagina moist, which may help prevent bouts of vaginal dryness.
- Avoid bubble baths, douches, and scented soaps or lotions. These can cause or increase vaginal dryness.
Vaginal dryness typically causes discomfort and pain but no other medical complications. However, untreated vaginal dryness may be associated with certain complications.
Vaginal dryness can cause an increased risk of urinary tract infections (UTIs) and recurring UTIs. Vaginal dryness can also cause serious pain with sex, which can lead to avoiding sex, intimacy issues, and less pleasurable sex.
Vaginal dryness occurs when estrogen decreases in your body. It most frequently happens during menopause and perimenopause.
Vaginal dryness can also occur after childbirth, during breastfeeding, or when you’ve had your ovaries removed. Cancer treatments and certain medications can also cause vaginal dryness.
Vaginal dryness can cause irritation, burning, itching, and painful sex. Effective treatments are available, including vaginal lubricants, moisturizers, and hormonal options.
