Many women experience vaginal dryness at some point in their lives. This uncomfortable condition, which can impact sex, tampon use, and general daily comfort, can be due to hormones, an underlying health condition, or a lack of sexual arousal. 

Additional lubrication can help make sex more comfortable, but there are other types of treatment depending on the cause of the dryness.

What Is Vaginal Dryness?

Women’s vaginas are pretty amazing. Not only can they expand to give birth to a child, facilitate menstruation, and offer sexual pleasure, but they also self-clean and self-lubricate.

Normally, the walls of the vagina are kept lubricated by a thin fluid that helps reduce friction and protect from infections like thrush, bacterial vaginosis, and sexually transmitted infections (STIs). It’s known as vaginal discharge or secretions, and it’s a normal, important part of having a vagina.

Vaginal secretions are produced all the time, but the production process is affected by things like a person’s hydration status, the hormone oestrogen, and overall mental and physical health. For example, during sexual arousal, more blood flows to the vagina, causing extra fluid to pass through the vaginal walls to lubricate the vagina before sex. But if oestrogen levels, blood flow, or the sexual arousal process are interrupted, it can lead to vaginal dryness.

Symptoms of Vaginal Dryness

Vaginal dryness affects every person differently, but some of the most common symptoms include:

• A painful or itchy vagina, including around the vaginal opening (introitus)
• Painful or uncomfortable sex/masturbation
• Bleeding or pain after sex
• Recurring UTIs (urinary tract infections) or needing to pee more often
• Abnormal vaginal discharge/less discharge than normal

These symptoms can both put women off having sex as well as lead to discomfort during normal daily activities.

What Causes Vaginal Dryness?

Low oestrogen levels

Around 50% of women who have gone through menopause experience vaginal dryness. Oestrogen levels drop as a normal part of ageing and the menopausal transition, which causes the lining of the vagina to become thinner, drier, and less elastic. This condition is known as vaginal atrophy.

Other causes of low oestrogen can also lead to vaginal atrophy and dryness, including the use of hormonal contraceptives, removal of the ovaries, hormonal shifts following childbirth, and hormonal changes during lactation.

Health conditions and medications

Hormonal contraceptives not only affect oestrogen levels (thus contributing to dryness), but they can also decrease libido, leading to mental and emotional contributions to vaginal dryness surrounding sexual activity. Studies suggest that not all women experience these side effects, but if you think your contraception is affecting your libido, it may be worth trying a different type. There are a wide variety of contraceptive options available that can suit different bodies and lifestyles.

There’s some evidence that other medications like antidepressants, cold medicines, antihistamines, and chemotherapy drugs can also cause libido changes and/or vaginal dryness.

Interestingly, several studies have also found a link between diabetes and  reduced vaginal lubrication, possibly due to nerve and blood vessel damage associated with this condition. Vaginal dryness is often also experienced in women with Sjogren’s syndrome – a rare autoimmune condition that can damage the body’s blood vessels and fluid-producing organs.

Psychological and emotional causes

Sexual arousal has both physical and emotional aspects. Many women find they need to become mentally aroused before they can experience physical arousal, including vaginal lubrication. Stress, relationship issues, and poor mental health are just some of the causes of low libido. A woman’s menstrual cycle can also impact libido and, consequently, the level of vaginal lubrication.

Lifestyle causes

Despite product claims, any kind of ”feminine hygiene” product is generally considered bad for vaginal health. Douching, or cleaning inside of the vagina, can wash away the vagina’s natural secretions and upset the delicate bacterial and pH balance, leading to vaginal dryness. Washing in or around the vagina with scented soaps, wipes, and washes can have similar effects.

Smoking may also increase the risk of vaginal dryness, possibly due to the impact it has on how oestrogen is metabolised by the body or by affecting blood flow.

The body needs to be properly hydrated to produce vaginal secretions, so dehydration is another cause of vaginal dryness.

Treatments for Vaginal Dryness

Vaginal dryness is uncomfortable and can significantly impact a woman’s sex life and emotional well-being, especially as it may feel like an embarrassing or isolating topic to discuss. However, it’s a very common condition, and fortunately, there are ways to treat it.

General Best Practices

Regardless of the cause, anyone experiencing vaginal dryness should avoid:

• Douching or washing inside the vagina
• Using strong or perfumed soaps and washes around the vulva and vagina

Washing with just warm water is the best way to stay clean whilst avoiding irritation and dryness.

Water-based lubricants can improve pleasure and comfort during sex or when masturbating. These types of lubricants can be used safely with condoms and most sex toys. However, these may contain irritating ingredients and preservatives, so you may have to try a few to find one that suits your skin type. It’s best to avoid using body or hand moisturisers, baby oil, petroleum jelly, mineral oils, and vegetable oils, as they can damage condoms and increase the risk of infections.

Depending on the cause, there are also more specific treatments available.

Treating Vaginal Dryness Caused by Low Oestrogen

Hormone replacement therapy (HRT) is used to replace oestrogen in women who are going through menopause or who no longer have periods, as well as postpartum women experiencing vaginal dryness and atrophy. HRT is available in various forms, but a topical cream is typically prescribed for dryness. Other local HRT options include vaginal tablets, pessaries, gels, and rings that are inserted into the vagina.

If localised HRT doesn’t work, your doctor may suggest other forms of HRT or a type of medication called a selective oestrogen receptor modulator (SERM). These treatments may result in side effects and aren’t suitable for everyone, so it’s important to discuss the options with your doctor.

Non-hormonal moisturisers and gels designed specifically for the vagina may also help with vaginal dryness caused by low oestrogen levels. Make sure to use medically approved brands – ask a healthcare professional for advice if you’re unsure.

Treating Vaginal Dryness Caused by Medication or Health Conditions

If you’re worried that your medication could be causing your vaginal dryness, speak to your GP. They may switch you to an alternative medication or suggest treatments to help with the lack of lubrication, like vaginal moisturisers or creams.

Similarly, if your medical condition could be affecting your vaginal lubrication or tissue elasticity, your doctor may be able to help manage the condition better or suggest suitable treatments.

In some cases, vaginal dryness can be caused by an infection. If you may have an STI, order ahome-testing kit from Yoxly or visit your local sexual health clinic.

Treating Vaginal Dryness Caused by Emotional Factors

If you think your lack of lubrication could be due to how you’re feeling mentally or emotionally, talking about it can help. Discussing your sex life with your partner could be the first step. What aspects of your sex life do you enjoy? Are there any things you’d like your partner to do differently? Are you feeling connected, or has there been a recent source of strain or distance? Everyone is different, and emotions surrounding sex can be complex. Don’t be afraid to explore the topic together and ask for what you need.

Relationship counselling can help you identify and work through issues in all aspects of your relationship, including sex. If you’re considering sex and relationship counselling, the organisation Relate is a great place to start. They have advice on everything from mismatched sexual fantasies to abusive relationships and can put you in touch with licensed psychosexual therapists and counsellors.

If you may be suffering from a mental health issue, it's important to connect with your doctor as well. They can offer advice on medications and support, including psychotherapies like CBT (cognitive behavioural therapy).

Summary

Vaginal dryness can be uncomfortable and even painful. If you’ve been struggling for more than a few weeks, are experiencing abnormal bleeding (including after sex), or find that vaginal dryness is affecting your daily life, speak to your GP. It's common but not something you have to live with, as treatments and tools may be able to help.