Vaginal Dryness After Menopause: Tips and Treatment Options

Last updated 01.15.2024 | by Dr. Karen Pike | 11 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.


Vaginal dryness is something many women face after menopause. A natural reduction in your body’s estrogen levels means your normal vaginal lubrication decreases too. As a result, sex can become painful, and the tissues in and around your vaginal area can become irritated. In some cases, this can even lead to infection.

So, it’s important to recognize the signs and symptoms of vaginal dryness and know how to treat the problem if it arises. 

Even within the menopause community, this uncomfortable symptom isn’t often discussed. But I know from my research that vaginal dryness affects a large proportion of post-menopausal women, and it’s a very common problem. 

So, if vaginal dryness is so prevalent, why aren’t more women speaking up? A lot of us might prefer to ignore the problem or pretend it doesn’t exist. However, many of our readers tell me that they wished there was more open discussion surrounding more intimate symptoms such as these. So, here at Simply Menopause, I’m striving to break the silence and educate more women about topics like vaginal dryness. 

Are you a postmenopausal woman who is suffering from pain and discomfort during sex? Vaginal dryness could be to blame. But thankfully, there are plenty of solutions that can help to alleviate the issue. 

In this post, I’ll discuss the causes of vaginal dryness after menopause, and the signs and symptoms to look out for. Then, I’ll share some effective treatment options that can help.

What Causes Vaginal Dryness After Menopause?

Vaginal dryness is a genitourinary syndrome of menopause (GSM) most commonly associated with post-menopausal women. It’s usually caused by low estrogen. Estrogen is the reproductive hormone responsible for keeping the vaginal tissues lubricated. So, when estrogen drops, the vagina often becomes dryer.

But estradiol doesn’t just maintain proper lubrication. It also keeps the lining of the vagina thick and elasticated. So, many women with lower postmenopausal estrogen levels also notice that their vaginal walls become thinner and less elastic as time passes.

This condition is called vaginal atrophy. It’s an extremely common part of the female aging process and one of the symptoms that you might expect to see in your post-menopause journey.

What Are the Symptoms of Vaginal Dryness?

the Symptoms of Vaginal Dryness

If you have post-menopausal vaginal atrophy and vaginal dryness, you might be experiencing symptoms such as:

  • Lower levels of vaginal discharge and lubrication
  • Tightening and narrowing of the vaginal opening
  • Itching in and around the vagina
  • Pain during penetrative sex
  • Light bleeding during penetrative sex
  • Irritation, soreness, and discomfort
  • A burning sensation
  • An increased risk of infection
  • Frequent urinary tract infections
  • Increased urgency and frequency of urination

Other Causes of Vaginal Dryness

The most common cause of vaginal dryness is a post-menopausal drop in estrogen. Vaginal dryness can also occur earlier in a woman’s life, during her perimenopausal phase. Estrogen fluctuates widely during perimenopausal transition, and if they fall below a certain threshold, vaginal dryness can occur.

But it’s not just perimenopause and menopause that can cause the condition. Estrogen can fall for various reasons during a woman’s life, including:

  • Breastfeeding
  • Childbirth
  • Excess stress
  • Depression
  • Polycystic ovarian syndrome (PCOS)
  • As a side effect of certain medication
  • Lifestyle factors such as poor diet and cigarette smoking
  • A type of autoimmune disorder called Sjögren syndrome
  • Surgical removal of the ovaries
  • Excessive bouts of exercise
  • Certain types of hormone therapy, radiation treatment, and chemotherapy

To cure vaginal dryness effectively, it’s important to identify why your estradiol levels are low. For many women, this drop in hormones is simply part of the post-menopausal process. But in some cases, there is another underlying cause.

Vaginal dryness and vaginal atrophy can have a serious impact on your quality of life. It can make sex extremely painful, which in turn can cause problems within your relationship. The condition can also affect your self-esteem and stop you from doing the day-to-day activities that you enjoy. In some cases, even light exercise, such as jogging, can be painful.

How to Treat Vaginal Dryness

How to Treat Vaginal Dryness

While this symptom of menopause is unpleasant at best, there is good news. Vaginal dryness is a treatable condition, and there are plenty of products, medications, and supplements out there that can help.

Seeking treatment for GSM early on can help you maintain an active and fulfilling sex life and keep you and your vagina happy and healthy. 

Intimate Lubricants

Perhaps the most obvious choice for treating vaginal dryness is a specially designed intimate lubricant. These types of lubes replace the fluids that your body is no longer producing for itself.

Using lubricant before intercourse reduces friction and rubbing. This makes sex a less painful and more pleasurable activity. Regular use of lube before and during sex also decreases the risk of infections.

Most vaginal lubricants are water-based formulas that are not absorbed into the skin. They can be purchased over the counter in most drugstores. But, if you’d prefer to be discreet, you’ll also find a wide variety of intimate lubes online.

Intimate Moisturizer

Unlike an intimate lubricant, intimate moisturizers aren’t usually designed for use before sex. Instead, they’re regularly applied externally and internally to boost moisture in and around the vagina. This helps to decrease rubbing and friction during daily activity.

Standard vaginal moisturizers add moisture and are available to buy over the counter without a prescription. When they’re used regularly, these products can improve the irritation, soreness, itching, and discomfort commonly associated with vaginal dryness.

Vaginal Estrogen Cream

Vaginal estrogen cream is a type of hormone replacement therapy. It’s used to treat not only vaginal dryness (it does this very well) and other signs of vaginal atrophy too. These include loss of tissue thickness and elasticity, itching, burning, pain during sex, and other urinary symptoms. Regular use can also significantly lower your risk of developing an infection.

This estrogen-boosting treatment most commonly comes in the form of a cream. However, low-dose vaginal estrogen tablets and rings, which are inserted into the vagina, are also available.

Unlike vaginal moisturizers, estrogen creams require a prescription. They’re not suitable for everyone, so talk to your doctor if you want to know if this treatment could benefit you.

Care should be taken when using this cream. Never apply the cream before sex. The high levels of estrogen can be absorbed by your partner, causing a potentially negative impact on their health.

Selective Estrogen Receptor Modulator (SERM) Medications

SERM medications such as Ospemifene (Osphena) come in pill form and should be consumed. They have been shown to have a positive effect on vaginal atrophy, including vaginal dryness, painful intercourse, soreness, and irritation. They also work to rebuild the vaginal tissues and rebalance your Ph levels to a more alkaline state.

Dehydroepiandrosterone (DHEA)

DHEA is a type of sex steroid hormone that is produced by the body naturally. It helps to boost other hormones, such as estradiol. So, supplementing with synthetic DHEA helps to increase your body’s own estrogen supply.

DHEA supplements have shown promise in treating postmenopausal vaginal atrophy symptoms, including vaginal dryness and painful intercourse. Plus, it’s also thought to improve bone density, treat depression, and even provide anti-aging benefits. Several readers have shared their DHEA success stories with me. It’s available to buy without a prescription in the USA, however, this supplement isn’t suitable for everyone. So, be sure to consult with your doctor before considering DHEA.

Regular Stimulation

Vaginal dryness shouldn’t stop you from enjoying an active and fulfilling sex life. In fact, regular sexual stimulation, either with a partner or by yourself, can actually improve your vagina’s ability to self-lubricate.

Penetrative sex or using a sex toy such as a vibrator can also help to strengthen the vaginal muscles that may have become weakened during and after menopause.

A Diet Rich in Phytoestrogens

Phytoestrogens are compounds found in plants. They have a similar chemical structure to the naturally occurring estrogen found in the body.

Studies have shown that phytoestrogens can have a beneficial impact on many of the symptoms of menopause, including vaginal dryness.

These plant-based substances are found in a wide variety of foods, including soybeans (and other soy-based products such as tofu), seeds, beans, carrots, coffee, oats, barley, and rice. Personally, I prefer to take soy supplements, which contain concentrated levels of phytoestrogens in measurable quantities.

Other Ways to Help Relieve Vaginal Dryness

Here are some further tips to help improve and manage vaginal health and dryness.

Enjoy More Foreplay

If sex is painful and lubrication alone isn’t enough to alleviate the problem, ask your partner to dedicate more time to foreplay. This can help you feel more aroused and stimulate your vagina’s natural lubrication.

Practice Pelvic Floor Exercises

Pelvic floor exercises are not just fantastic for urinary incontinence. When done on a regular basis, they can also help to strengthen your vaginal walls and increase the vaginal secretion of fluids.

Avoid Tight Underwear and Synthetic Fabrics

Synthetic fabrics such as polyester trap heat and make you sweat, which can exacerbate irritation and itching. Stick to loose-fitting underwear made from natural breathable material. If possible, go without pants entirely while you sleep at night.

Avoid Perfumed Soaps, Creams, Toilet Paper, and Sanitary Products

Scented and perfumed products can inflame your vaginal tissues. This can lead to irritation and potentially even infection.

FAQs

Q. How do I talk to my partner about vaginal dryness during menopause?

According to a 2012 survey, more than 70% of menopausal women said that their relationships and sex lives suffered due to symptoms such as vaginal dryness. But this doesn’t have to be the case.
The vast majority of women will experience vaginal dryness and irritation to some degree. So, there’s no need to be embarrassed.
Talk openly with your partner about your symptoms of dryness and how you feel. Being honest and upfront will help them understand the natural changes you’re going through and lessen the risk of your relationship being impacted.

Q. Does vaginal dryness go away?

Unfortunately, unlike many other menopause symptoms(e.g., hot flashes and night sweats), vaginal dryness usually remains long after menopause is complete. In fact, it often tends to get worse with time.
Thankfully, there are plenty of treatments that can help, such as using vaginal estrogen therapy and more.

Q. How can I talk to my doctor about vaginal dryness?

Talking to your doctor about vaginal dryness is the first step to finding relief. But some women understandably find it hard to discuss such a personal aspect of their lives and body with their healthcare provider.
If it makes you feel more comfortable, you can ask to speak with a female doctor and she may help you with a treatment plan.
But don’t avoid the conversation. As a doctor myself let me assure you that we are here to support every aspect of your menopausal health. Yet sadly, less than half of women talk to their physicians about this particular symptom. And as a result, less than 5% actually receive treatment.

Conclusion

Vaginal dryness is a common complaint among postmenopausal women. A drop in the body’s estradiollevels can also lead to a drop in our natural ability to self-lubricate. This can impact your sex life, your relationship, and your self-esteem.

Vaginal dryness can cause significant discomfort even when performing regular day-to-day activities. Plus, the risk of developing an infection rises significantly.

But thankfully, vaginal dryness is a treatable condition. There are various products, medications, vaginal tablets, and supplements that can help relieve your symptoms.

If you’re worried about post-menopausal vaginal changes such as dryness, irritation, and itching, don’t suffer in silence. Book an appointment with your doctor to explore the range of several treatment options.

References:

Author

  • Dr. Karen Pike

    Dr. Pike is a senior physician administrator and board-certified emergency room doctor actively working in northern California. She received her undergraduate degree at Dartmouth College, where she graduated Phi Beta Kappa and played collegiate soccer. She attended Georgetown University for medical school and performed her residency in emergency medicine at Stanford University. She was part of the first-ever, women-majority emergency medicine program in United States. Dr. Pike is also the primary medical consultant for “Grey’s Anatomy,” a role she has held since the pilot episode when she partnered with Shonda Rhimes as the show’s original medical consultant. At her hospital, she was the second woman Chief of Staff. Today serves as the Director of the Emergency Department. Whether in leadership or direct patient care, her dedication to excellence in communication, quality, and collaboration is unwavering.