Vaginal dryness is a pretty common problem during menopause, and it is typical of the genitourinary syndrome known as atrophic vaginitis or vaginal atrophy. This condition makes vaginal tissues thinner and easily irritated due to the natural decrease in oestrogen levels that occurs most frequently during menopause (1).  

According to the National Health Service (2), the changes in oestrogen levels experienced in menopause are one of the leading causes of vaginal dryness. This hormonal imbalance can diminish the amount of vaginal discharge or secretions, causing uncomfortable symptoms such as pain or itching. 

Possible complications and consequences of vaginal dryness in menopause

Vaginal dryness experienced in menopause can start from perimenopause. This symptom can make sex uncomfortable or painful and cause minor cuts in your vagina during sexual activity. These cuts can also increase the risk of contracting sexually transmitted infections (3) vaginal dryness cause discomfort in the pelvic and vaginal regions. Dryness in the vagina can also bring consequences such as (4, 5): 

• Thrush or Bacterial Vaginosis (BV). 

• Burning when urinating. 

• Loss of interest in sex. 

• Light bleeding after sexual intercourse. 

• Urinary tract infections (UTIs) —such as cystitis — that do not go away or that may recur. 

Tips to combat vaginal dryness

There are simple and effective treatments to treat the causes of dryness during menopause. These treatments can help minimize your symptoms and include the application of a vaginal lubricant, creams, gels, patches, among others. Also, hormone therapy increases oestrogen levels which can help to alleviate the symptoms (2). Here you can find eight tips to deal with vaginal dryness during menopause that will help you feel better. 

1. Use vaginal moisturizers

 Vaginal moisturizers can help keep your vagina moist and make sex more comfortable. They are available over the counter. Those water or silicone-based are recommended because they have ingredients such as dimethicone that help restore moisture in the vaginal area. Apply them several times a week to keep vaginal tissues healthy. Their effects last slightly longer than a vaginal lubricant (6, 7). 

2. Apply vaginal lubricants to reduce discomfort during sexual intercourse

A vaginal lubricant can be used to supplement moisturizers before sexual intercourse. Vaginal lubricants are also available over the counter, and water-based or silicone-based are mostly recommended. You can apply them before and during sex to reduce vaginal dryness and relieve pain and discomfort (4, 7). 

Choose those without glycerine, perfumes, herbal extracts, or artificial colours, as they irritate the vagina. Avoid using petroleum jelly and mineral oil as a vaginal lubricant, as they can damage the latex in condoms, which increases the risk of vaginal infections and pregnancy (4, 7). 

3. Use unscented soaps for intimate hygiene

Neutral intimate soaps for the hygiene of your vulva and vagina will help keep it healthy. It is a good idea to look for products that are dermatologically and gynaecologically tested. It may also be helpful to avoid products containing surfactants, perfumes, or soapy substances, as these can alter the pH of the vagina and damaging its tissues (2, 5). It is preferable to choose products made with natural ingredients like aloe vera, tea tree oil, thyme, or coconut oil that provide moisture. 

4. Maintain an active lifestyle to fight dryness

Exercising and maintaining an active sex life positively impacts the quality of life (8). These two activities can vaginal dryness during menopause, as your body remains healthy and can increase stamina during sexual intercourse (7). You can do exercises to strengthen your pelvic floor and tone your vagina. In addition, sexual arousal increases blood flow in the genital area and produces natural lubrication (7). 

5. Keep a healthy diet with essential nutrients

Having a healthy diet that provides vitamins and minerals helps alleviate the symptoms of menopause. Eat foods rich in B vitamins such as lentils, meats, and eggs, and foods that provide vitamin B3 and A help maintain normal mucous membranes, including the vagina (9).  

These nutrients are found in beef, eggs, nuts, dairy, and grains like wheat. Vitamin B3 helps form hormones and can prevent symptoms such as vaginal dryness. Eat fruits and vegetables such as oranges, tomatoes, and paprika, which contain vitamin C, a nutrient that helps the normal formation of collagen (9). Include in your diet those foods that provide phytoestrogens, such as isoflavones, which are substances that can have some effects similar to oestrogen. These are found in vegetables like soybeans and spinach and can improve dryness. Also, ask your doctor if you need to include supplements of these nutrients to improve menopausal symptoms (10, 11). 

6. Increase water consumption

Increasing your water intake will help keep your body hydrated, which favours the production of natural lubricants. It is necessary to drink enough water so that the vaginal region is hydrated (12). About 8 to 11 glasses can help keep the skin moist and prevent swelling caused by hormonal changes (13). 

7. Try herbal supplements that help relieve vaginal dryness

Herbal supplements can be taken in teas, capsules, and other forms. They can be used as an alternative therapy to control or relieve vaginal dryness and other symptoms of menopause. Black cohosh, red clover, Dong Quai, maca, and other herbs have phytoestrogens that work in a similar way to oestrogen and can help alleviate these symptoms (11). 

8. Oestrogen hormone therapy

If other methods do not work, physician-guided oestrogen hormone therapy can relieve vaginal dryness. It is used in two ways: topically in the vagina in low doses and orally in higher doses. It is crucial to consult your gynaecologist/GP if you want to use hormone therapy. Here are some options (7, 3). 

• Low-dose oestrogen creams and gels to help keep the vagina moist. 

• A vaginal ring that releases a constant low dose of oestrogen to relieve symptoms of dryness. There are also rings with higher amounts of oestrogen levels for managing other menopause symptoms, such as moderate or severe hot flushes. 

• Low-dose oestrogen suppositories or vaginal tablets that release the hormone periodically. 

• In some cases, oral pills or skin patches with higher doses of oestrogen, often combined with progesterone. 

Vaginal dryness appears during menopause due to the decrease in oestrogen production. It can affect your self-esteem and your sexual activity, in addition to causing discomfort in the vaginal area. Try these tips to combat it and keep your vagina moist. Using these remedies will help you feel better.

References 

1. Vaginal atrophy [Internet]. Mayo Clinic. 2021 [cited 2024 Oct 14]. Available from: https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/diagnosis-treatment/drc-20352294 
2. Vaginal dryness [Internet]. NHS. 2021 [cited 2024 Oct 14]. Available from: https://www.nhs.uk/conditions/vaginal-dryness/ 
3. Menopause treatment [Internet]. OASH | Office on Women’s Health. [cited 2024 Oct 14]. Available from: https://www.womenshealth.gov/menopause/menopause-treatment 
4. Nall R. Vaginal dryness: Causes, symptoms, and more [Internet]. Healthline. 2019 [cited 2024 Oct 14]. Available from: https://www.healthline.com/health/vaginal-dryness 
5. Jacobson JD. Vaginal dryness [Internet]. MedlinePlus. 2023 [cited 2024 Oct 14]. Available from: https://medlineplus.gov/ency/article/000892.htm 
6. Menopause symptoms and relief [Internet]. OASH | Office on Women’s Health. 2021 [cited 2024 Oct 14]. Available from: https://www.womenshealth.gov/menopause/menopause-symptoms-and-relief 
7. Marnach M. Vaginal dryness after menopause: How to treat it? [Internet]. Mayo Clinic. 2024 [cited 2024 Oct 14]. Available from: https://www.mayoclinic.org/diseases-conditions/menopause/expert-answers/vaginal-dryness/faq-20115086 
8. Almuqahwi A, Alabdrabulridha H, Aljumaiah RM, Alfaifi AJ, Alnaim MF, Alfaifi IA, et al. A systematic review on the relationship between physical activity and sexual function in adults. Cureus 2023;15(12):e51307. Available from: http://dx.doi.org/10.7759/cureus.51307 
9. McDermott A. Vitamins for menopause: What works? [Internet]. Healthline. 2023 [cited 2024 Oct 14]. Available from: https://www.healthline.com/health/menopause/vitamins-for-menopause 
10. Jacobson JD. Vaginal dryness alternative treatments [Internet]. MedlinePlus. 2023 [cited 2024 Oct 14]. Available from: https://medlineplus.gov/ency/article/002142.htm 
11. Hill A, RD, LD. 10 herbs and supplements for menopause [Internet]. Healthline. 2020 [cited 2024 Oct 14]. Available from: https://www.healthline.com/nutrition/menopause-herbs 
12.  Vaginal dryness [Internet]. Cleveland Clinic. [cited 2024 Oct 14]. Available from: https://my.clevelandclinic.org/health/symptoms/21027-vaginal-dryness 
13. How much water do you need to stay healthy? [Internet]. Mayo Clinic. 2022 [cited 2024 Oct 14]. Available from: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/water/art-20044256