Menopause and Vaginal Dryness: What You Need to Know

The walls of the vagina typically have a thin layer of moisture on them. This moisture is secreted by the cells of the vaginal walls and helps sperm survive and travel. It also reduces friction during sexual intercourse.

When estrogen production starts to decline in menopause, vaginal secretions and moisture lessen, and vaginal dryness may occur.

Symptoms of vaginal dryness may include:

• irritation, burning, or itching
• lowered sex drive
• post-sex bleeding
• recurring urinary tract infections

Vaginal dryness can cause discomfort and painful intercourse, and it can negatively affect quality of life.

Vaginal dryness during and after menopause happens because changes in hormone production cause the vaginal walls to thin. This means there are fewer cells producing moisture, leading to vaginal dryness. Reduced estrogen levels is the most common cause of vaginal dryness, and this is associated with menopause.

Some people with vaginas experience vaginal dryness even before menopause, and that could be due to a variety of reasons. Other factors that may cause or contribute to vaginal dryness include:

• cigarette smoking
• depression
• high stress levels
• immune system disorders
• some cancer treatments

Vaginal dryness due to menopause can be bothersome and even painful, but there are treatments available, both over-the-counter and prescription. Medical treatments that can be prescribed for you include:

• Vaginal estrogen therapy:
  • estrogen cream applied to or inserted into the vagina
  • vaginal estradiol tablets
  • estradiol vaginal ring: this is a ring containing estrogen that’s inserted into the vagina for 90 days at a time
• Standard doses of estrogen therapy. Sometimes this type of estrogen therapy is combined with vaginal creams.
• Ospemifene. This medication is administered in an oral tablet that is an estrogen agonist/antagonist for vaginal atrophy.
• Dehydroepiandrosterone (DHEA). DHEA is a type of hormone that’s inserted into the vagina to help treat painful intercourse.

Talk with your gynecologist or healthcare professional about whether any of these treatments are appropriate for you. If you have a history of certain cancers, you may want to consult your oncologist before taking anything.

Vaginal atrophy can contribute to vaginal dryness. If this is the case for you, there are some natural remedies that you might try, including:

• herbs and supplements
• diet
• exercise

For more about natural treatments for vaginal atrophy, read this article.

There are also over-the-counter personal lubricants that you might try, like Astroglide or Replens. Natural oils like almond oil or coconut oil may also provide some relief.

Regular sexual stimulation helps encourage vaginal blood flow and secretions. You can do this with a partner or by yourself.

Before using any home remedies for vaginal dryness, talk with your doctor or healthcare professional. Ask them if the remedy is safe to use or if there are any known adverse effects. Products that are all-natural or herbal are not necessarily safe to use, particularly in the genital area.

Vaginal secretions and moisture reduce friction during sexual intercourse. This helps make it more comfortable. Without enough lubrication, sex may be uncomfortable or even painful. During and after menopause, vaginal dryness can cause changes in your sex life because of the discomfort associated with sex.

There are things you can do to help reduce pain during sex and add lubrication to the vaginal area. This can include things like:

• Vaginal moisturizers. Vaginal moisturizers add moisture to and around the vagina. They can be inserted for internal moisture or applied to the vulva to add moisture there.
• Lubricants. Lubricants help reduce discomfort during sex and can be used in addition to a vaginal moisturizer.
• Vaginal dilators. Vaginal dilators can help stretch and enlarge the vagina if tightening occurs. These should be used under the guidance of a gynecologist, physical therapist, or sex therapist.
• Pelvic floor exercises. These exercises can also help strengthen and relax certain vaginal muscles.

Vaginal dryness due to menopause is a manageable condition. Treatments like lifestyle changes, lubricants and moisturizers, and hormone therapies (both systemic and local) are all very effective in treating menopausal vaginal dryness.

Menopause can bring many bodily changes, including vaginal dryness. It can feel uncomfortable and embarrassing, but it is highly treatable and manageable.

Talking with your doctor or other healthcare professional to find a treatment plan that works best for you will help improve your quality of life and minimize your symptoms.