Vaginal dryness and the menopause

Samantha Wild
Clinical Lead for Women's Health and Bupa GP
29 October 2020
Next review due October 2023

Have you been feeling a bit dry and sore ‘down there’? Started having discomfort during sex? If you think you might be leading up to or have reached the menopause, these symptoms could be connected. But there are things you can do that can help.

Does vaginal dryness go away?

Vaginal dryness is thought to affect between half and three quarters of people who are either perimenopausal (the stage leading up to the menopause) or who have reached the menopause. Unlike most menopause symptoms, it’s unlikely to go away on its own and tends to get worse with time.

What causes vaginal dryness?

As you reach the menopause, your ovaries gradually stop making the hormone oestrogen. Oestrogen does many things, including helping to keep your muscles and ligaments strong. It also boosts the collagen in your skin, which helps to keep it hydrated and supple.

When your oestrogen levels drop, the walls of your vagina become thinner, drier and less flexible. They’re also more easily irritated. As part of this process your body also produces fewer vaginal secretions, so your vagina is less well lubricated. A lack of oestrogen can affect other areas such as your labia, clitoris, and bladder.

All of this can impact your physical health and your enjoyment of sex. If vaginal dryness gets in the way of normal life, it can also affect your mental health, too. So, it’s important to know that there are treatments available, and things you can do to help.

What does vaginal dryness feel like?

The symptoms of a dry vagina include:

  • soreness, for example when wearing jeans or sitting down
  • burning and/or itching
  • inflammation, leading to redness and discharge
  • going for a wee more often
  • urinary tract infections (UTIs), especially after sex
  • pain, tearing or bleeding during sex

These symptoms can also be caused by something other than the menopause, so it’s best to speak to your GP about what is happening. Try not to be embarrassed about talking to your doctor, and remember they are used to seeing all sorts of conditions. If you’re able to get some help, it will be worth it.

Is there a vaginal dryness cure?

Although there isn’t a cure, there are lots of treatment options. If your doctor thinks your vaginal dryness is due to the menopause, they might suggest:

  • a vaginal moisturiser for use on a regular basis
  • water-based vaginal lubricants to use before you have sex
  • a hormone cream or a gel that you apply to your vagina
  • hormone replacement therapy (HRT) as a general treatment for menopausal symptoms

What helps vaginal dryness before and after the menopause?

There are also some self-help options for vaginal dryness that you can try.

  • Wear only cotton underwear.
  • If sex is painful, as well as lubricants, it may also help to try to enjoy more foreplay so that you feel more aroused.
  • Do pelvic floor exercises.

There are also some things that might be helpful to avoid.

  • Avoid wearing pants when you sleep.
  • Don’t wear tight clothing around your crotch that makes you sweat.
  • Don’t use douches (washing your vagina from the inside).
  • Avoid scented toilet paper, tampons or pads.
  • Don’t use perfumed soaps or creams near your vagina.
  • Don’t insert moisturisers or lubricants not designed for vaginal use.

We know that, like cervical screening (smear tests), vaginal dryness can be something that some people avoid seeing doctors about because of embarrassment. More than half of people with vaginal dryness don’t want to talk to their doctor about it. However, I really want to encourage you to, because the menopause is a natural stage of life and one that I think we need to be more open about. After all, half the population goes through it.

If you’re struggling with menopause symptoms, or want to support someone who is, we’re here to help. There’s lots of information, expert advice and signposting on the menopause pages within our Women’s Health Hub, and you don’t need to be a Bupa customer to access any of it.

Samantha Wild
Dr Samantha Wild
Clinical Lead for Women's Health and Bupa GP

    • Moral E, Delgado J, Carmona F et al. The impact of genitourinary syndrome of menopause on well-being, functioning, and quality of life in postmenopausal women. Menopause 2018: 25(12): 1418-1423. doi: 10.1097/GME.0000000000001148
    • Kim HK, Kang SY, Chung YJ et al. The recent review of the genitourinary syndrome of menopause. J Menopausal Med. 2015;21(2):65-71. doi:10.6118/jmm.2015.21.2.65
    • Chidi-Ogbolu N, Baar K. Effect of estrogen on musculoskeletal performance and injury risk. Front Physiol 2019. 9:1834. doi:10.3389/fphys.2018.01834
    • Don't ignore vaginal dryness and pain. Harvard Health Publishing., published March 2019
    • Naumova I, Castelo-Branco C. Current treatment options for postmenopausal vaginal atrophy. Int J Womens Health. 2018; 10:387-395. doi:10.2147/IJWH.S158913
    • Vaginal dryness. Women's Health Concern., reviewed September 2020
    • Ghandi J, Chen A, Dagur G et al. Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. AJOG 2016; 215(6): 704-711

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