Vaginal Dryness: Why It Happens and What You Can Do About It

Vaginal dryness is a common but often overlooked aspect of women's intimate health. Although frequently associated with menopause, it can occur at many different stages of life, affecting everyday comfort, sexual wellbeing and confidence. The good news is that effective treatments and practical solutions are available.

Vaginal dryness is something many women experience but relatively few feel comfortable talking about. Despite growing openness around menopause, sexual wellbeing and women's health, intimate discomfort can still be a difficult subject to raise with a partner, friend or healthcare professional.

For some women, the first sign is discomfort during sex. Others may experience itching, soreness, irritation or a persistent feeling of dryness that affects everyday activities.

These symptoms can be confusing, particularly when they appear unexpectedly or during a stage of life when we might not associate ourselves with hormonal changes.

Although vaginal dryness is especially common during perimenopause and after menopause, it can also occur following childbirth, while breastfeeding, during certain medical treatments or as a side effect of medication.

Whatever the cause, it is important to recognise that vaginal dryness is not something women simply have to accept as an inevitable part of ageing or changing hormones.

Understanding why it happens is the first step towards finding appropriate relief.

What is vaginal dryness?

Vaginal dryness occurs when the tissues of the vagina have insufficient natural moisture or lubrication, potentially causing irritation, discomfort or pain.

The vagina normally maintains moisture through natural secretions that help protect its tissues and support comfort during everyday activities and sexual intimacy.

Oestrogen plays an important role in maintaining the health, elasticity and thickness of vaginal tissues.

When oestrogen levels decline, these tissues can become thinner, drier and more delicate. Natural lubrication may also decrease.

However, hormonal changes are not the only possible cause.

Vaginal dryness may also be associated with irritation from personal care products, certain medications, insufficient arousal during sexual activity or underlying health conditions.

What are the symptoms of vaginal dryness?

Symptoms can vary considerably between individuals.

Some women experience occasional dryness during sex, while others notice persistent discomfort.

Common symptoms include:

• A feeling of dryness or irritation inside or around the vagina.

• Itching, burning or soreness.

• Discomfort or pain during sexual intercourse.

• Reduced natural lubrication during intimacy.

• Sensitivity or irritation around the vaginal opening.

• Discomfort during certain everyday activities.

During menopause, vaginal dryness may also occur alongside urinary symptoms, including increased urinary urgency or recurrent urinary tract infections.

These symptoms are sometimes grouped under the term genitourinary syndrome of menopause (GSM).

Because similar symptoms can be caused by infections, skin conditions or other health problems, persistent discomfort should be assessed rather than automatically attributed to dryness.

What causes vaginal dryness?

There are several reasons why vaginal lubrication may decrease, and identifying the likely cause can help determine the most appropriate treatment.

1. Perimenopause and menopause

Menopause is one of the most common causes of persistent vaginal dryness.

As oestrogen levels fluctuate during perimenopause and decline after menopause, changes can occur in the vaginal tissues.

These changes may lead to dryness, irritation, reduced elasticity and discomfort during sexual activity.

Unlike some other menopausal symptoms, vaginal dryness may continue or become more noticeable over time without appropriate treatment.

Women experiencing these symptoms do not necessarily need to be taking systemic hormone replacement therapy to receive treatment.

Local vaginal oestrogen and non-hormonal products are among the options recommended in clinical guidance.

2. Pregnancy and breastfeeding

Hormone levels change significantly during pregnancy and after childbirth.

Breastfeeding can be associated with lower oestrogen levels, which may contribute to vaginal dryness and reduced lubrication.

For some women, this can make returning to sexual intimacy after childbirth uncomfortable.

Physical recovery, tiredness, emotional adjustment and changes in sexual desire may also influence intimacy during this period.

Vaginal moisturisers or suitable lubricants may provide relief, but persistent symptoms should be discussed with a healthcare professional, particularly when there has been childbirth-related injury or ongoing pain.

3. Certain medications

Some medications can contribute to vaginal dryness.

These may include certain hormonal contraceptives, antidepressants and medicines that affect hormone levels.

Cancer treatments, including chemotherapy, radiotherapy and some hormone therapies, can also cause changes in vaginal tissues and lubrication.

If symptoms begin after starting a new medication, speak to your GP or prescribing clinician.

Do not stop or change prescribed treatment without medical advice.

4. Stress and changes in sexual arousal

Stress, anxiety, relationship difficulties and tiredness can influence sexual desire and arousal.

When someone does not feel sufficiently aroused, the body may produce less lubrication during sexual activity.

This does not necessarily mean that there is a hormonal problem or a lack of attraction towards a partner.

Emotional wellbeing, physical comfort, relationship dynamics and previous experiences can all influence how the body responds to intimacy.

Taking more time for arousal, communicating openly and removing pressure around sexual activity may help.

However, persistent dryness should not simply be dismissed as psychological, particularly when symptoms also occur outside sexual activity.

5. Irritation from intimate hygiene products

The vulva and vagina are sensitive to certain ingredients commonly found in personal care products.

Perfumed soaps, fragranced washes, deodorants and vaginal douches can cause irritation and disrupt the normal environment of the genital area.

The vagina is self-cleaning and does not require internal washing or douching.

For everyday hygiene, gently washing the external genital area with warm water and, if preferred, a mild unperfumed product is generally sufficient.

Avoid using ordinary body lotions or products not intended for vaginal use to treat internal dryness.

6. Underlying health conditions

Occasionally, vaginal dryness may be associated with an underlying medical condition, such as diabetes or Sjögren's syndrome.

Certain inflammatory or dermatological conditions affecting the vulva can also produce discomfort that may be mistaken for simple dryness.

If symptoms persist, worsen or are accompanied by unusual discharge, bleeding or significant pain, seeking medical advice is important.

How can vaginal dryness affect sexual wellbeing?

For many women, one of the most distressing aspects of vaginal dryness is its effect on intimacy.

Sex that was previously comfortable may become painful, leading to anxiety about future sexual experiences.

Over time, anticipating discomfort can influence arousal, confidence and the desire for physical closeness.

Some women begin avoiding penetrative sex because they associate it with pain, while others continue despite discomfort because they worry about disappointing their partner.

Neither situation is ideal.

Pain during sex is a signal that deserves attention, not something that should be ignored or endured.

It is also important to recognise that intimacy does not have to involve penetration.

Affection, touch, communication and other forms of physical closeness can help couples maintain connection while seeking appropriate treatment.

A supportive partner can make an important difference by listening without judgement and understanding that vaginal dryness is a physical health concern rather than a reflection of attraction or affection.

What is the best treatment for vaginal dryness?

The most appropriate treatment depends on the underlying cause, how frequently symptoms occur and whether they are related to hormonal changes.

For some women, an over-the-counter lubricant or moisturiser provides sufficient relief.

Others may benefit from prescription treatment, particularly when symptoms are associated with menopause.

1. Vaginal lubricants for immediate comfort

Personal lubricants are designed to reduce friction during sexual activity.

They can be particularly helpful when natural lubrication is insufficient or when intercourse causes discomfort.

Water-based lubricants are widely available and are generally a practical first option.

Some people prefer silicone-based lubricants because they typically remain slippery for longer and may require less frequent reapplication.

Choose products specifically designed for intimate use, and consider avoiding fragrances or ingredients that cause irritation.

If using condoms, check that your chosen lubricant is compatible with them.

Oil-based products can damage latex condoms, increasing the risk of breakage.

Lubricants can make intimacy more comfortable, but they do not necessarily address an underlying hormonal cause of persistent vaginal dryness.

2. Vaginal moisturisers for ongoing dryness

Vaginal moisturisers differ from lubricants because they are designed to provide longer-lasting moisture rather than simply reducing friction during sexual activity.

They may be used regularly according to the product instructions, regardless of whether someone is sexually active.

This makes them particularly useful for women experiencing ongoing dryness, irritation or discomfort throughout the day.

Many vaginal moisturisers are available without a prescription.

A pharmacist can help you choose a suitable product, especially if you have sensitive skin or are unsure whether a moisturiser or lubricant would be more appropriate.

3. Vaginal oestrogen for menopause-related dryness

For women experiencing vaginal dryness associated with menopause, local vaginal oestrogen is an established treatment option.

Unlike systemic hormone replacement therapy, which delivers hormones throughout the body, vaginal oestrogen is applied directly to vaginal tissues.

It is available in several forms, including creams, tablets, pessaries, gels and vaginal rings.

The treatment helps address changes associated with declining oestrogen levels, rather than only providing temporary lubrication.

According to NICE guidance updated in 2024, vaginal oestrogen can be used alone or alongside non-hormonal moisturisers and lubricants for genitourinary symptoms associated with menopause.

Only a small amount of oestrogen is absorbed into the bloodstream with low-dose vaginal treatment, and serious side effects are rare.

However, individual medical circumstances still matter, and anyone considering hormonal treatment should seek suitable professional advice.

Some vaginal oestrogen preparations are available from pharmacies for eligible women, while others require a prescription.

4. Other treatments for persistent symptoms

If vaginal oestrogen and non-hormonal approaches have not provided sufficient relief, other treatment options may be considered.

NICE guidance includes vaginal prasterone as a possible option when vaginal oestrogen or non-hormonal treatments have been ineffective or are not tolerated.

An oral medicine called ospemifene may also be considered in certain circumstances where locally applied treatments are impractical.

These treatments are not suitable for everyone and require an individual medical assessment.

Women who have a history of breast cancer or are receiving hormone-related cancer treatment should discuss vaginal symptoms with their oncology or menopause care team.

Non-hormonal moisturisers and lubricants are generally considered first, with decisions about vaginal oestrogen made according to individual circumstances and clinical guidance.

Vaginal lubricant or moisturiser: which should you choose?

Although the terms are sometimes used interchangeably, these products serve different purposes.

Some women benefit from using both: a moisturiser for everyday comfort and a lubricant during sexual activity.

If symptoms continue despite using suitable products, additional treatment may be needed.

Can lifestyle changes help vaginal dryness?

Although persistent hormonal vaginal dryness may require medical treatment, certain everyday habits can help reduce irritation and support intimate comfort.

Avoid harsh or fragranced products

Choose gentle, unperfumed products for the external genital area and avoid vaginal douching.

Take time during intimacy

Allowing sufficient time for arousal, using lubricant and communicating about comfort can help reduce friction and discomfort during sex.

Avoid continuing when sex is painful

Pain is not something that should be pushed through.

If penetrative sex causes discomfort, stop or change activities rather than risking further irritation.

Consider pelvic health support

For some women, painful intercourse involves more than dryness alone.

Pelvic floor muscle tension, childbirth-related changes or other pelvic health concerns may contribute.

A pelvic health physiotherapist can assess whether specialist support may be helpful.

Review medications when appropriate

If you suspect a medication may be contributing to dryness, ask your GP or prescribing clinician whether there are suitable alternatives.

Never discontinue prescribed medication independently.

When should you see a GP about vaginal dryness?

Although vaginal dryness is common, it is important not to assume that persistent symptoms are simply part of ageing.

The NHS recommends seeking medical advice if dryness continues for several weeks despite self-care, interferes with daily life or is accompanied by unusual discharge or bleeding.

You should also arrange an assessment if you experience:

• Bleeding after sex.

• Bleeding between periods.

• Any vaginal bleeding after menopause.

• Persistent pain during sexual activity.

• Unusual discharge, itching or irritation.

• Recurrent urinary symptoms or suspected infections.

These symptoms can have several causes, many of which are treatable, but some require further investigation.

A GP, sexual health clinician or menopause specialist can help identify the underlying problem and recommend appropriate treatment.

Talking to your partner about vaginal dryness

Discussing intimate discomfort can feel awkward, particularly if the symptoms have affected your relationship or sexual confidence.

However, honest communication can help prevent misunderstandings.

You might explain that hormonal changes, medication or another health issue are affecting your physical comfort and that you would like to explore ways to make intimacy enjoyable again.

Rather than focusing exclusively on penetrative sex, consider what forms of affection and closeness feel comfortable for both of you.

If pain has created anxiety or tension around intimacy, psychosexual therapy or relationship counselling may also be helpful.

There is no requirement to maintain a particular level of sexual activity to be healthy, and every woman's preferences and experiences are different.

The most important consideration is that intimacy should be consensual, comfortable and enjoyable rather than something endured out of obligation.

Vaginal dryness is treatable at every stage of life

Vaginal dryness can affect women during reproductive years, after childbirth, throughout perimenopause and long after menopause.

For some, symptoms are temporary and improve as hormone levels or circumstances change. For others, particularly following menopause, ongoing treatment may be needed.

What matters is recognising that effective options exist.

From suitable moisturisers and lubricants to vaginal oestrogen and specialist support, treatments can help women regain comfort and confidence.

There is no need to accept persistent discomfort as an unavoidable part of growing older, nor should anyone feel embarrassed about asking for help.

Intimate health is an important part of overall wellbeing, and looking after it deserves the same attention as any other aspect of physical and emotional health.

Frequently asked questions about vaginal dryness

What is the main cause of vaginal dryness?

Declining oestrogen levels are a common cause, particularly during perimenopause, menopause and breastfeeding. However, vaginal dryness can also be associated with certain medications, insufficient arousal, irritating products and underlying medical conditions.

Can you experience vaginal dryness before menopause?

Yes. Vaginal dryness can affect women of any age, including during pregnancy, breastfeeding or while using certain hormonal contraceptives or other medications.

What is the difference between vaginal lubricants and moisturisers?

Lubricants reduce friction during sexual activity and provide short-term comfort. Vaginal moisturisers are designed for ongoing dryness and can be used regularly, independently of sexual activity.

What is the most effective treatment for menopause-related vaginal dryness?

Local vaginal oestrogen is an established treatment for menopausal vaginal symptoms. Non-hormonal lubricants and moisturisers can also help and may be used alone or alongside vaginal oestrogen, depending on individual preferences and clinical needs.

Does vaginal dryness mean you have a low sex drive?

Not necessarily. Vaginal lubrication and sexual desire are related but distinct. A woman may experience desire while having insufficient lubrication because of hormonal changes, medication or other factors.

Can vaginal dryness cause painful sex?

Yes. Reduced lubrication can increase friction and make intercourse uncomfortable or painful. Persistent pain should be assessed because it can also have other causes.

Is vaginal oestrogen the same as HRT?

Vaginal oestrogen is a form of local hormone replacement therapy used to treat vaginal and some urinary symptoms associated with menopause. Unlike systemic HRT, it delivers a low dose directly to the affected tissues and has minimal absorption into the bloodstream.

Can vaginal dryness go away on its own?

Sometimes. Dryness associated with temporary hormonal changes, medication or irritation may improve when the underlying cause changes. Menopause-related dryness can persist and may require ongoing treatment.

Should I see a doctor about vaginal dryness?

Yes, if symptoms persist, affect daily life or are accompanied by unusual discharge, bleeding or significant pain. Vaginal bleeding after menopause should always be medically assessed.

Editorial note: This article was originally supplied to Wellbeing Magazine by a commercial intimate wellbeing brand. It has been substantially rewritten and independently updated by the Wellbeing Magazine Editorial Team to provide general, evidence-informed information without endorsing particular products.

Medical disclaimer: This article is intended for general information and does not replace professional medical advice. Anyone experiencing persistent vaginal dryness, pain or unusual symptoms should consult an appropriate healthcare professional.