Menopause Vaginal Dryness

Causes and Treatments for this Persistent Problem


The effects of menopause vaginal dryness can be very irritating – literally.

It is not only one of the reasons for painful sexual intercourse, but also for infections(urinary track infections, vaginal infections) and
an itching or burning sensation. It is also one of the causes for reduced libido or lack of sexual desire.

This symptom is a normal sign of menopause and is caused by by vaginal atrophy – a thinning of the vaginal lining. 

The good news is that there are many things you can do to treat this condition. Your option range from:

  • Hormone treatments
  • Natural remedies
  • Even some lifestyle changes

For many women the problem begins during perimenopause and becomes more noticeable and bothersome with time.

Causes of Vaginal Dryness

Menopause vaginal dryness is caused by lower estrogen levels. Normally, a thin layer of a clear fluid keeps the lining of the vagina lubricated and healthy. The fluid is released through membranes and a gland (Bartholin’s gland) in the vagina. During intimacy, the blood flow to the vagina increases and causes more moisture to be released.

When estrogen levels drop, the vaginal lining becomes thinner and does not produce as much of this fluid. This is called vaginal atrophy, which causes menopause vaginal dryness. Sometimes an inflammation of the vaginal lining develops which is called atrophic vaginitis.

If you experience unusual vaginal discharge or irritation, have a pelvic exam to rule out any infection or other illness.

The lack of moisture and resulting inflammation can cause itching and burning, and certainly painful intercourse.

The lack of lubrication changes the chemical balance in the vagina and makes it more prone to irritation and injury. It also makes infections (both vaginal and urinary) more likely.

To complicate matters, vaginal dryness may or may not be hormone related.Other causes such as irritations, infections or medications can be the culprit.

Here are some of the causes of non-menopause vaginal dryness:

  • Certain medications such as anti-histamines for allergies or cold medication
  • Smoking and alcohol use (both dehydrate the body)
  • Irritation because of chemicals in douches, soaps or lotions (if you are very sensitive)
  • Childbirth and breastfeeding (because of lower estrogen levels during this time)
  • Infections and sexual transmitted diseases
  • Cancer treatments such as radiation or chemotherapy
  • Certain diseases (Sjogren’s syndrome, Thyroid)
  • As a result of a hysterectomy or removal of ovaries (lack of estrogen)
Treatment for Vaginal Dryness

The main goal of any treatment for vaginal dryness in menopause is to restore the moisture balance. You have several options to treat this symptom:

  • Estrogen therapy
  • Natural remedies
  • Lifestyle options
Estrogen Options

Because low estrogen is the culprit for your symptoms, estrogen treatments will help, either as part of a menopause hormone treatment or just through local (topical) estrogen applications.

Local estrogen therapy works well to alleviate the symptoms of menopause vaginal dryness. Some women, who are concerned about potential risks of hormone replacement, prefer the vaginal estrogen because only minor amounts enter the bloodstream (unlike oral estrogen supplements that are distributed throughout the body in the bloodstream and are metabolized by the liver).

The topical estrogen can be delivered in several ways:

  • Estrogen Cream (i.e. Premarin, Estrace)
  • Estrogen Gel (i.e. Elestrin, Estrogel)
  • Vaginal Suppositories/ tablets (i.e. Vagifem)
  • Vaginal Ring (i.e. Estring Femring)

Which prescription is best for you depends on your individual needs and preferences. Some women have negative reactions to the cream and prefer a gel. Others report that the gels are messier and go for suppositories or tablets.

You need to decide which is best for you in consultation with your health care provider.

Early in perimenopause, estrogen therapy (other than vaginal estrogen) might not be the best choice because of highly fluctuating estrogen levels. If you add additional hormone into the mix, you may experience estrogen dominance symptoms.

However, if you also experience frequent urinary tract or vaginal infections, estrogen therapy (especially topical application) might be a good choice for your menopause vaginal dryness.

Natural Remedies for Vaginal Dryness

If vaginal dryness during sex is your main concern, vaginal lubricants or moisturizers might be all you need. Numerous brands such as Replens, Probe or Astroglide are available at your local pharmacy or online. Use them liberally before and during intimacy, and daily for personal comfort. Do not use petroleum or oil based products because they can lead to infections.

Vitamin E is another option. There are Vitamin E suppositories as well as a liquid form. Some women just use Vitamin E capsules and either cut them open or use them like a vaginal suppository.

There are many natural remedies for vaginal dryness. A diet rich inphytoestrogens (plant estrogen) such as Flaxseed will support your other treatments and may provide relief for minor symptoms.

Dr. Christiane Northrup in her book, The Wisdom of Menopause, suggests using whole soy (such as Revival Soy) in higher than recommended doses for a shorter amount of time to alleviate menopause vaginal dryness.

Other natural remedies for vaginal dryness are herbs such as Red Clover or Dong Quai. These herbs contain phytoestrogens as well.

Lifestyle Options

It is very important to increase the fluid intake to keep body hydrated. Drink plenty of water or herbal teas (try Red Clover Ice Tea) and avoid sodas or sugary drinks.

Avoid feminine douches because they can contain chemicals that may irritate the sensitive skin in the vaginal area. Douches are not a good choice especially during menopause.

Use only very mild soaps or shower gels to avoid that you dry out the skin even more.

A Final Word

Menopause vaginal dryness is a painful and irritating symptom. Some lucky women report that the symptoms get better during post menopause.

For most women however, the permanent drop in estrogen means that this symptom will persist.

Try some of the natural remedies for vaginal dryness and if these don’t alleviate your symptoms, talk to your doctor about topical estrogen therapy.



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