What Causes Vaginal Dryness?

Written by WebMD Editorial Contributors
Medically Reviewed by Nivin Todd, MD on May 19, 2023
6 min read

Vaginal dryness occurs when there's dryness and thinning of the tissues in your vagina.

Normally, the walls of the vagina stay lubricated with a thin layer of clear fluid. The hormone estrogen helps maintain that fluid and keeps the lining of your vagina healthy, thick, and elastic.

A drop in estrogen levels reduces the amount of moisture available. It can happen at any age from a number of causes.

It may seem like a minor irritation. But the lack of vaginal moisture can have a huge impact on your quality of life. Fortunately, several treatments are available to relieve vaginal dryness.

 

Vaginal dryness is a common symptom of menopause. About 1 in 6 women between the ages of 18 and 50  experience the condition during sex.It becomes even more common after menopause, when more than 50% of women have vaginal dryness. It also makes the vaginal tissue thinner and less elastic (known as  vaginal atrophy).

Estrogen levels can also drop because of:

  • Childbirth and breastfeeding
  • Radiation, hormone therapy, or chemotherapy treatment for cancer
  • Surgical removal of the ovaries
  • Anti-estrogen medications used to treat uterine fibroids or endometriosis
  • Any form of hormonal birth control
  • Diabetes

Other causes of vaginal dryness include:

  • Sjögren's syndrome (an autoimmune disorder that attacks cells in the body that produce moisture)
  • Allergy and cold medications
  • Certain antidepressants and antihistamines
  • Use of scented products in or around your vagina
  • Not enough foreplay before sex

No matter what the cause, vaginal dryness can be very uncomfortable. It can lead to itching, burning, and pain during sex.

Any burning, itching, or discomfort in the area is worth a call to your doctor or gynecologist. They'll ask about your medical history and find out how long you've had symptoms and what seems to make them worse or better.

Your doctor will do a pelvic exam, checking your vagina for any thinning or redness. The exam will help rule out other causes for your discomfort, including a vaginal or urinary tract infection. The doctor may also remove cells from your vaginal wall or cervix for a Pap test to rule out other conditions or a blood test to check your estrogen levels.

The most common treatment for vaginal dryness due to low estrogen levels is topical estrogen therapy. These replace some of the hormones your body is no longer making. That helps relieve vaginal symptoms, but it doesn't put as much estrogen in your bloodstream as the hormone therapy you take in pills.

There are many types of vaginal estrogen therapy, including:

Ring (Estring, Femring)

You or your doctor inserts this soft, flexible ring into your vagina, where it releases a steady stream of estrogen directly to the tissues. The ring is replaced every three months.

Tablet (Vagifem, Osphena) 

You use a disposable applicator to put a tablet into your vagina once a day for the first two weeks of treatment. Then you do it twice a week until you no longer need it.

A tablet taken orally once a day, ospemifeme (Osphena), makes vaginal tissue thicker and less fragile, resulting in less pain for women during sex. The FDA warns that Osphena can thicken the endometrium (the lining of the uterus) and raise the risk of stroke and blood clots.

Vaginal inserts

Imvexxy. With Imvexxy, an insert is placed into your vaginal canal every day for two weeks, and then twice a week.

Intrarosa. This is a steroid in the form of a vaginal insert. It may cause vaginal discharge, and you may have an abnormal Pap test.

Hyaluronic acid-based vaginal suppositories. These inserts, for example Revaree, can also safely keep the vagina lubricated. It can be bought online through major retailers or the manufacturer.

Cream (Estrace, Estradiol, Premarin)

You use an applicator to get the cream into your vagina. You'll typically apply the cream daily for one to three weeks, then cut back to one to three times a week as directed by your doctor.

Any estrogen product can have side effects, such as vaginal bleeding and breast pain. Topical estrogen may not be recommended when you:

  • Have breast cancer, especially if you're taking an aromatase inhibitor
  • Have a history of endometrial cancer
  • Have unexplained vaginal bleeding
  • Are pregnant or breastfeeding

There isn't much research on the long-term use of topical estrogen, but women who still have their uterus may have an increased risk of developing endometrial cancer .

 Other treatment options for vaginal dryness include nonhormonal therapy.

Vaginal moisturizers

One of the best ways to reduce vaginal dryness is to use a vaginal moisturizer. These are special moisturizers that are made specifically for this sensitive area of the body. Using a vaginal moisturizer every few days can help keep your vagina moist and relieve vaginal dryness symptoms.

You can apply the moisturizer a few times a week before bed. Apply it around the walls of the vagina to let it absorb. Don't try to use a moisturizer or cream that is not specifically for the vagina. Similarly, you should avoid scented soaps, moisturizers, or other toiletries.

You can buy a vaginal moisturizer like glycerin-min oil-polycarbophil (Replens) at your local drugstore or supermarket.

Water-based lubricants

Before sexual activity, apply a water-based lubricant (Astroglide, K-Y) in your vagina and on your partner where there will be contact. Using a lubricant can help relieve any pain or discomfort you might normally experience during sex.

Be sure to choose a lubricant that doesn't contain petroleum jelly or glycerin. Glycerin can cause your vagina to become even more irritated, and petroleum jelly can cause condoms to weaken or break during sex.

Regular sexual activity

Having sexual stimulation regularly can help improve your overall vaginal health. You can do this either alone or with a partner, or even using a device like a vibrator. Sexual stimulation helps increase blood flow and vaginal secretions and relieves vaginal dryness.

If you're having sex with a partner, try engaging in foreplay before intercourse. This can make you feel more aroused so that sex is more enjoyable and comfortable. This can also help promote blood flow and secretions to the vagina.

New approach to sex

While sexual activity is good for your vaginal health, rethink the way you approach it. As mentioned, foreplay can be very helpful in getting ready for intercourse. Once you begin intercourse, take it slow. This helps give the Bartholin's glands time to produce more natural lubrication in your vagina.

You can also try other sexual activities that don't involve intercourse but still let you be intimate with your partner. Activities such as massaging, mutual masturbation, oral sex, or simply touching can be fulfilling. These activities are typically more comfortable if your vaginal dryness symptoms are especially bothersome.

Pelvic floor exercises

Pelvic floor exercises can help strengthen weak vaginal muscles. With lower levels of estrogen, vaginal muscles weaken over time. Exercises like Kegels can help relax tight muscles and strengthen weaker ones. These exercises also help increase blood flow to the vagina.

Vaginal dilators. These tools are another nonhormonal, nonprescription option to help to stretch and activate muscles in your vagina. They can be used with physical therapy if your symptoms are severe.

If you've tried these remedies for vaginal dryness and are still experiencing discomfort, see your doctor. Your doctor can talk to you about other treatment options that can help.

Vaginal dryness is a common condition that happens when the tissues of your vagina become more dry and thinner. A drop in estrogen is a main cause. Vaginal dryness can happen at any age from a number of causes and there are many hormonal and nonhormonal treatment options.

How can you moisturize a private area? 

Moisturizers and lubricants can be used for treating vaginal dryness. Moisturizers are effective for a longer time, as they stick to the tissue surrounding the vagina and help the cells keep moisture. Lubricants are for use during sex and are effective for a shorter time. 

How can you reverse vaginal atrophy? 

There's no cure for vaginal atrophy, but there are treatment options for managing your symptoms.