How to Deal With Vaginal Dryness

14 min read
Vaginal dryness causes and treatment options

Vaginal dryness can cause itching, burning, soreness, a feeling of tightness and discomfort during sex or when inserting something into the vagina.

Itโ€™s particularly common during perimenopause and after menopause, but it can happen at other stages of life too.

The good news is that you donโ€™t have to simply put up with it. Vaginal moisturisers and lubricants can make a big difference for many people, and if lower oestrogen is contributing to the problem, prescription treatments such as vaginal oestrogen can be very effective.

The best option depends on whatโ€™s causing the dryness, whether itโ€™s occasional or ongoing and how much itโ€™s affecting you.

Key takeaways

  • Lower oestrogen during perimenopause and after menopause is one of the most common causes of vaginal dryness, but it isnโ€™t the only cause.
  • Vaginal moisturisers are designed to provide ongoing moisture and are generally used regularly.
  • Lubricants provide temporary slip and are useful during sex or when inserting a menstrual product or other device.
  • Some people use both a moisturiser and lubricant.
  • If dryness is related to menopause, low-dose vaginal oestrogen can be a very effective treatment.
  • Persistent itching, burning, pain, unusual discharge or urinary symptoms may have another cause and are worth checking.
  • Bleeding after sex, between periods or after menopause needs medical assessment.

On this page

What is vaginal dryness?

Vaginal dryness simply means there isnโ€™t enough moisture or lubrication in or around the vagina for you to feel comfortable.

That can show up as dryness or irritation during everyday life, or you may mainly notice friction or discomfort during sex, exercise or when inserting a tampon, menstrual cup, disc or another product.

Vaginal moisture naturally changes throughout life and across the menstrual cycle. Hormones, sexual arousal, medicines, pregnancy, breastfeeding, menopause and your general health can all affect how the vulva and vagina feel.

Dryness isnโ€™t a reflection of cleanliness, sexual desire or how well you look after your body.

It is also very common. Vaginal, vulval and urinary changes related to declining oestrogen affect a large proportion of people during and after the menopause transition.

What causes vaginal dryness?

There are several possible causes, and sometimes more than one is involved.

Lower oestrogen during perimenopause and menopause

Oestrogen helps maintain the thickness, elasticity, blood supply and moisture of vaginal and vulval tissue.

As oestrogen levels change during perimenopause and menopause, the tissue can become thinner, drier and more easily irritated.

You may also notice changes in the vulva, discomfort during sex, more frequent urination or recurrent urinary tract infections.

Together, these changes are known as genitourinary syndrome of menopause, or GSM.

Unlike hot flushes, which often settle over time, vaginal and urinary symptoms caused by low oestrogen can continue after menopause and may become more noticeable without treatment.

Our guide to vaginal health during perimenopause explains these changes in more detail.

Breastfeeding

Oestrogen levels are often lower while breastfeeding, which can leave the vaginal tissue feeling drier or more sensitive.

For many people this improves as breastfeeding becomes less frequent and hormone levels change again.

Removal of the ovaries

Surgery that removes both ovaries causes a sudden fall in ovarian hormones and can lead to vaginal dryness and other menopause symptoms.

A hysterectomy by itself doesnโ€™t necessarily cause the same hormonal change if the ovaries are left in place, although menopause may occur somewhat earlier for some people after hysterectomy.

Medicines and medical treatments

Some medicines can contribute to vaginal dryness, including some antidepressants.

Chemotherapy, pelvic radiotherapy and hormone-blocking treatments used for some cancers can also have a significant effect on vaginal and vulval tissue.

If you suspect a prescribed medicine is contributing, talk with your doctor rather than stopping it yourself.

Irritating products

Perfumed washes, intimate cleansers, sprays, wipes, douches and fragranced bath products can irritate sensitive vulval and vaginal tissue and make dryness feel worse.

The vagina is self-cleaning and doesnโ€™t need to be washed internally.

Gentle external washing is generally enough. If something consistently stings, burns or leaves you irritated, stop using it.

Read our guide to douching and vaginal health for more.

Sexual arousal, stress and pain

The vagina usually becomes more lubricated with sexual arousal, but the amount varies enormously between people and from one occasion to another.

Stress, tiredness, anxiety, pain, medication, relationship factors and hormonal changes can all influence arousal and natural lubrication.

And importantly, needing lubricant does not mean you arenโ€™t attracted to your partner or donโ€™t want sex.

Plenty of people use lubricant simply because sex feels better with it.

Other causes

Dryness, soreness, itching and burning can also be caused by vulval skin conditions, dermatitis, infections and other health conditions.

If symptoms persist, particularly if you also have unusual discharge, significant itching, pain or skin changes, itโ€™s worth having them checked rather than assuming hormones are responsible.

What does vaginal dryness feel like?

Vaginal dryness can feel different from person to person.

You might notice:

  • dryness or tightness in or around the vagina
  • a feeling of friction
  • itching, burning, stinging or soreness around the vaginal opening or vulva
  • discomfort during sex
  • pain when inserting a tampon, menstrual cup, disc or other internal product
  • soreness after sex
  • small tears or irritation after friction
  • discomfort when sitting, walking or exercising
  • needing to urinate more frequently
  • recurrent urinary tract infections, particularly when dryness is part of GSM

These symptoms can have other causes too.

Unusual discharge, persistent odour, significant itching or worsening pain may point to an infection or another condition that needs a different treatment.

Our guide to vaginal discharge and whatโ€™s normal can help you understand what tends to be typical and what is worth getting checked.

How to manage vaginal dryness

There isnโ€™t one right way to manage vaginal dryness.

If symptoms are mild or occasional, lubricant may be all you need. If dryness is there most of the time, a vaginal moisturiser can provide more ongoing comfort.

And when dryness is caused by the hormonal changes of menopause, prescription vaginal oestrogen can make a significant difference.

1. Try a vaginal moisturiser for ongoing dryness

Vaginal moisturisers are designed to provide longer-lasting moisture rather than simply adding temporary slipperiness during sex.

They can be useful if you feel dry or uncomfortable during everyday life, not just during sexual activity.

Depending on the product, vaginal moisturisers are commonly used several times a week.

Follow the instructions for the particular product because formulations differ. Some are designed for internal vaginal use, while others are intended only for the external vulval area.

You can browse Period Shopโ€™s intimate moisturisers.

2. Use lubricant when you need more slip

Lubricant is designed to reduce friction when you need it.

You might use it during penetrative sex, masturbation, pelvic floor exercises or when inserting a menstrual cup, disc, tampon, dilator or another device.

Thereโ€™s no prize for managing without lube. If adding lubricant makes something more comfortable, use it.

Water-based lubricant

Water-based lubricants are versatile and generally compatible with latex condoms and most sex toys and devices.

They can absorb or dry out more quickly than silicone lubricants, so you may need to reapply them.

Silicone-based lubricant

Silicone lubricants usually stay slippery for longer and can be particularly useful when vaginal tissue is dry or when you want longer-lasting lubrication.

Check compatibility before using silicone lubricant with a silicone toy or device, as manufacturer recommendations differ.

Oil-based lubricant

Oil-based products can provide long-lasting slip but should not be used with latex condoms because oils can weaken latex and increase the chance of breakage.

They may also not be suitable for every internal product or toy, so check compatibility.

Our guides to choosing the right lubricant and why adding lubricant can make a difference explain the options in more detail.

You can also browse Period Shopโ€™s lubricants.

3. Reduce irritation

If the area already feels dry or sensitive, simpler is often better.

Avoid douching and stop using fragranced washes, wipes, sprays or other products that sting or irritate your skin.

You donโ€™t need to scrub or wash inside the vagina.

Products used externally around the vulva and products designed for internal vaginal use arenโ€™t necessarily interchangeable, so check what a product is actually made for.

4. Make sex and insertion more comfortable

Give yourself time and use as much lubricant as you need.

For sex, more time for arousal can increase natural lubrication for some people, although hormonal dryness may still mean extra lubricant is useful.

If youโ€™re inserting a menstrual cup, disc or another product, a small amount of water-based lubricant around the vaginal opening or on the product may make insertion easier.

Lubricant can reduce friction, but it shouldnโ€™t be used to push through persistent pain.

If penetration remains uncomfortable, pelvic floor muscle tension, vulval skin conditions, infection, GSM or another condition may be contributing.

A pelvic health physiotherapist can help when pelvic floor tension or pain is part of the problem.

You might also find these guides useful:

Lubricant or vaginal moisturiser: which do you need?

Vaginal moisturiser Lubricant
Best for Ongoing vaginal dryness Reducing friction when needed
When you use it Regularly, according to product directions During sex, masturbation or insertion
How long it works Designed to provide longer-lasting moisture Temporary lubrication
Use even when not having sex? Yes Usually not necessary

A vaginal moisturiser may suit you if dryness is noticeable most days or you want something designed to improve ongoing comfort.

A lubricant may be all you need if you mainly notice friction during sex or insertion.

And plenty of people use both: a moisturiser regularly and lubricant whenever extra slip is useful.

If you have sensitive skin, starting with a simple product without fragrance, warming, cooling or tingling ingredients can be a good option.

What about vaginal oestrogen?

If vaginal dryness is related to perimenopause or menopause, vaginal oestrogen can be a very effective treatment.

Unlike systemic menopausal hormone therapy, which is designed to circulate through the body, low-dose vaginal oestrogen is applied directly to the vaginal tissue where itโ€™s needed.

In Australia, vaginal oestrogen is available in forms including creams, vaginal tablets and ovules, depending on the product prescribed.

It can help restore moisture, thickness and elasticity to vaginal tissue and may also improve some urinary symptoms associated with genitourinary syndrome of menopause.

Absorption into the bloodstream is very low when low-dose vaginal oestrogen is used as recommended.

At recommended vaginal doses, a progestogen generally isnโ€™t needed simply to protect the uterus.

Vaginal oestrogen can also be used alongside systemic menopausal hormone therapy if vaginal symptoms continue.

It may take several weeks to achieve its full effect, so donโ€™t assume it isnโ€™t working after only a few applications.

What if youโ€™ve had breast cancer?

People who have had breast cancer can still experience significant vaginal dryness, particularly after treatments that reduce oestrogen levels.

Moisturisers and lubricants are generally the first things to try.

If symptoms remain troublesome, vaginal oestrogen may sometimes still be considered after an individual discussion with your GP, oncologist or breast cancer specialist.

This is particularly important if youโ€™re taking an aromatase inhibitor, because these medicines are designed to keep circulating oestrogen extremely low.

You donโ€™t need to simply live with severe vaginal discomfort after breast cancer treatment. There are options, but the best choice needs to take your individual cancer treatment into account.

When should you see a GP?

See your GP if:

  • vaginal dryness has continued for several weeks and what youโ€™ve tried isnโ€™t helping enough
  • symptoms affect your sleep, everyday life, intimacy or wellbeing
  • you have persistent itching, burning or pain
  • you have unusual discharge or a persistent unpleasant smell
  • penetration or inserting products is painful
  • you have urinary symptoms or repeated urinary tract infections
  • you notice ongoing vulval skin changes

Also get medical advice for bleeding after sex or between periods.

Any vaginal bleeding after menopause should be assessed.

Heavy bleeding, severe pelvic pain, fever or feeling very unwell may need urgent medical attention.

If youโ€™re not sure how to bring it up, our guide to talking to a doctor about vaginal concerns can help you prepare for the appointment.

Frequently asked questions

Does vaginal dryness go away on its own?

It depends on the cause. Dryness linked to breastfeeding or a temporary medicine may improve when hormone levels or treatment change. Vaginal dryness associated with menopause often continues unless it is managed, but moisturisers, lubricants and prescription treatments can make a significant difference.

Is vaginal dryness normal during perimenopause?

Itโ€™s common. Changing oestrogen levels during perimenopause can affect the moisture, thickness and elasticity of vaginal and vulval tissue. Common doesnโ€™t mean you have to tolerate it, though. Effective options are available if itโ€™s uncomfortable.

Can vaginal dryness cause urinary tract infections?

Genitourinary syndrome of menopause can affect both vaginal tissue and the urinary tract and is associated with recurrent UTIs. Vaginal oestrogen can reduce UTI recurrence for some postmenopausal people. Repeated UTIs should still be discussed with your GP.

Is vaginal oestrogen the same as regular hormone therapy?

Not quite. Low-dose vaginal oestrogen is placed directly in the vagina and mainly acts locally on vaginal and urinary tissue, with very little absorption into the bloodstream. Systemic menopausal hormone therapy uses tablets, patches, gels or other preparations designed to have effects throughout the body.

Do I need progesterone with vaginal oestrogen?

At recommended low vaginal doses, a progestogen generally isnโ€™t required solely to protect the lining of the uterus because systemic absorption is very low. Your prescriber can advise you based on the product and your individual health history.

Can I use lubricant with a menstrual cup or disc?

Yes. A small amount of water-based lubricant around the vaginal opening or on the rim of a cup or disc can make insertion more comfortable. Check the product instructions if youโ€™re using another type of lubricant.

Can I use coconut oil as a lubricant?

Some people like oil-based lubricants, including coconut oil, but oil can weaken latex condoms and may not be suitable for every toy or internal product. Check compatibility before using it. If youโ€™re prone to irritation, a purpose-made lubricant may also be easier to troubleshoot if your skin doesnโ€™t like it.

Can vaginal moisturiser be used as lubricant?

It depends on the product. Some intimate moisturisers can also provide useful lubrication while others are designed primarily for regular moisture between sexual activity. Check the manufacturerโ€™s instructions rather than assuming the two uses are interchangeable.

Does needing lubricant mean Iโ€™m not aroused enough?

No. Natural lubrication varies with hormones, age, medication, stress and plenty of other factors. You can be completely aroused and still benefit from lubricant. If it makes sex or insertion more comfortable, thatโ€™s reason enough to use it.

Finding what works for you

Vaginal dryness is common, but it isnโ€™t something you have to accept as an unavoidable part of ageing, breastfeeding or hormonal change.

Sometimes the solution is as simple as adding lubricant. Ongoing dryness may respond better to a vaginal moisturiser. And when low oestrogen is driving the change, vaginal oestrogen can be a very effective option.

If something feels dry, sore or painful, you donโ€™t need to keep pushing through it or wait until it becomes severe before asking for help.

You can browse Period Shopโ€™s lubricants and intimate moisturisers, or speak with your GP if you think hormonal changes or another condition may be contributing.

Related reading

Sources and further reading

This article provides general educational information and isnโ€™t a substitute for individual medical advice.