Vaginal Dryness

What is vaginal dryness?

Normally, your vaginal lining is lubricated with fluid produced by glands at the neck of the womb (the cervix).^1,3 Oestrogen affects these glands, helping them to produce vaginal moisture which moves slowly down through the vagina, keeping it clean, supple and moist^.3,4 This moisture is slightly acidic and helps to prevent infections, like thrush.³

Vaginal dryness is when the tissues in your vagina are dry, thin and not well-moisturised, due to falling levels of oestrogen.^1,2 This is because a lack of oestrogen can cause the tissues around your vagina to become thinner and your glands to reduce in number.⁴ As a result, your vaginal tissues become irritated and cause discomfort.^1,2

Vaginal dryness symptoms

Vaginal dryness is not just uncomfortable on its own but can lead to other symptoms of vaginal dryness, such as:^1,3–7

• Burning and itching
• Pain of discomfort during sex
• Bleeding after sex due to your vaginal wall tissues breaking open
• A sore or itchy vulva
• Recurrent urinary tract infections (utis) or yeast infections (thrush)
• Needing to pee more often
• Not wanting to have sex (loss of libido)
• Pain when peeing
• Discomfort when you sit, stand or move
• Changes in the appearance of the vagina
• Changes to your vaginal discharge
• A loss of sexual confidence

When to see a GP

You should see a GP if:⁵

• You've had vaginal dryness for a few weeks and it’s not responding to any treatments
• Vaginal dryness is affecting your daily life
• You have unusual discharge from your vagina
• You’re experiencing bleeding after sex, in between your periods or after menopause

Causes of vaginal dryness

Vaginal dryness is caused when your body does not produce enough oestrogen.⁵ This most commonly occurs as a result of the menopause.⁵ In fact, according to our latest menopause statistics report, at least half of women who have gone through the menopause have some vaginal dryness and this number increases over time.⁴

It’s thought that vaginal dryness is even more common than this, but that many women don’t report their symptoms due to embarrassment.⁴

However, other factors can also trigger a change in your hormone levels and cause vaginal dryness, such as:^1,3–7

• Not being sufficiently aroused during sex
• Using perfumed soaps or other hygiene products in or around your vagina
• Using swimming pools or hot tubs
• Being pregnant
• Breastfeeding
• Certain medications (such as antihistamines, cold and flu medicine, antidepressants and hormonal contraceptives)
• Having chemotherapy, radiotherapy, hormone therapy or surgery to treat cancer
• Having diabetes
• Anti-oestrogen medications
• Having a hysterectomy (your womb and/or ovaries removed)
• Sjogren’s syndrome (an autoimmune disorder)

How is vaginal dryness diagnosed

Typically, your GP will diagnose vaginal dryness by asking you a few questions about your symptoms and medical history.¹ However, they may also perform a:¹

• Pelvic exam – to look at the inside of your vagina and see if it looks dry (thin and red)
• Blood test – to find out whether your hormone levels or another condition may be contributing to your vaginal dryness

They may also test your vaginal discharge to check for any signs of an infection.¹

How to treat vaginal dryness

If you are experience other symptoms of the menopause, you may be recommended to try hormone replacement therapy (HRT), as this can also help to relieve vaginal dryness.⁴ HRT involves replacing your body’s normal levels of oestrogen using skin patches, a gel or spray, an implant or tablets.⁸

Other treatments for vaginal dryness include:^1,2,3,4

• Vaginal lubricants – you can put a lubricant into the vagina or on the vulva or penis just before having sex to simulate natural lubrication and make sex more comfortable and pleasurable. You should be aware that water-based lubricants can damage condoms
• Vaginal moisturisers – you can put a vaginal moisturiser into your vagina or around your vulva two to three times a week to keep vaginal tissues moist and healthy. These last for up to three days, so do not need to be applied directly before you have sex
• A low-dose vaginal oestrogen cream, tablet or ring –these can be inserted into your vagina to restore oestrogen in that area without increasing it throughout your body. They tend to be prescribed for use every day for about two weeks, until you get relief, and then used weekly as needed. Although oestrogen-containing rings can be placed into your vagina for up to three months, then replaced. Your symptoms may come back after your stop using the treatment. You should be aware that vaginal rings should not be used alongside vaginal lubricants. Additionally, oestrogen creams for vaginal dryness may damage latex condoms and diaphragms

Sources

1. https://my.clevelandclinic.org/health/symptoms/21027-vaginal-dryness
2. https://www.mayoclinic.org/diseases-conditions/menopause/expert-answers/vaginal-dryness/faq-20115086
3. https://www.womens-health-concern.org/wp-content/uploads/2023/11/25-WHC-FACTSHEET-VaginalDryness-OCT2023-B.pdf
4. https://best.barnsleyccg.nhs.uk/media/grrgjqim/atrophic-vaginitis-vaginal-dryness-patient-information-sheet-2018.pdf
5. https://www.nhs.uk/symptoms/vaginal-dryness/
6. https://www.healthdirect.gov.au/vaginal-dryness
7. https://patient.info/womens-health/menopause/vaginal-dryness-atrophic-vaginitis
8. https://www.nhs.uk/conditions/menopause/treatment/