Vaginal Dryness

A thin layer of moisture coats the walls of the vagina. This moisture provides an alkaline environment that sperm can survive in and travel in for sexual reproduction. These vaginal secretions also lubricate the vaginal wall, reducing friction during sexual intercourse.

As a woman ages, changes in hormone production can cause the vaginal walls to thin. Thinner walls mean fewer cells that secrete moisture. This can lead to vaginal dryness. Hormonal changes are the most common cause of vaginal dryness, but they are not the only cause.

Vaginal dryness can cause:

  • Burning
  • Loss of interest in sex 
  • Pain with sexual intercourse
  • Light bleeding following intercourse
  • Soreness
  • Urinary tract infections (UTIs) that do not go away, or that reoccur 
  • Vaginal itching or stinging
  • Discomfort in the vaginal and pelvic regions.

Falling estrogen levels are the chief cause of vaginal dryness. Women begin to produce less estrogen as they age. This leads to the end of menstruation during a time called perimenopause. 

However, menopause is not the only condition that causes a decrease in estrogen production. Other causes include:

  • Breastfeeding 
  • Cigarette smoking
  • Depression
  • Excessive stress
  • Immune system disorders, such as Sjögren syndrome
  • Childbirth
  • Rigorous exercise 
  • Some cancer treatments, such as radiation to the pelvis, hormone therapy, or chemotherapy
  • Surgical removal of the ovaries
  • Menopause
  • Some medications
  • Douching
  • Fragrance feminine products  
  • Surgical removal of ovaries
  • Allergies and cold medications
  • Certain antidepressants
  • Not enough foreplay before sex

Hormone therapy may not be the right treatment for everyone. Some women are not good candidates for hormones because of a past history of disease, such as cancer.

Replacing natural estrogen can help with dryness but can also trigger side effects. These include:

  • Weight gain
  • Fluid retention
  • Nausea
  • Headaches
  • breast tenderness
  • Spotting of the skin
  • Increased risk of stroke, blood clots, and breast and ovarian cancers

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When to seek medical help

Vaginal dryness rarely indicates a serious medical condition. But seek help if the discomfort lasts beyond a few days or if you experience discomfort during sexual intercourse. If left untreated, vaginal dryness can cause sores or cracking in the vagina’s tissues.

If the condition is accompanied by severe vaginal bleeding, seek immediate medical attention.

During an exam, your doctor may examine the vaginal walls to look for lacerations or feel for thinning skin. They may also take a sample of vaginal discharge to test for the presence of harmful bacteria.

Additionally, hormone tests can determine if you are in perimenopause or menopause.

How is virginal dryness treated?

There are many over-the-counter lubricants that can be applied to the vaginal area to reduce dryness and discomfort. These lubricants and moisturizing creams can also change the vagina’s pH, reducing the likelihood of getting a UTI.

Women should choose a lubricant specifically intended for vaginal use. The lubricant should be water-based. They shouldn’t contain perfumes, herbal extracts, or artificial colors. These can cause irritation.

Lubricants such as petroleum jelly and mineral oil can damage latex condoms and diaphragms used for birth control.

In some instances, a healthcare provider will prescribe estrogen therapy in the form of a pill, cream, or ring, which release estrogen.

Creams and rings release estrogen directly to the tissues. Pills are more likely to be used when you have other uncomfortable menopause symptoms, such as hot flashes.

Because many products can irritate delicate vaginal skin, it’s important to seek evaluation and treatment advice at a physician’s office if the condition persists.

Bottom line:
No matter what the cause, if left untreated, vaginal dryness can cause sores or cracking in the vagina’s tissues and painful intercourse. Consult a doctor for best advice. 

Mayo Clinic Staff. (2018). Vaginal dryness.
Treating vaginal dryness. (n.d.).
Vaginal dryness. (2017).
Kendall, A. Dowsett, M. Folkerd, E. and Smith, I. Annals of Oncology. Published online Jan. 27, 2006.
Nothnagle, M. Scott Taylor, J. American Family Physician, 2004; vol 69: pp 2111-2112.
MedlinePlus: "Estrogen Vaginal."
Agency for Healthcare Research and Quality: "Management of menopause-related symptoms."