Vaginal dryness is a common problem, particularly during and after menopause, yet many women put up with it for years without seeking help. Gynaecologists stress that it is treatable and that there are options to suit almost everyone.
The role of vaginal moisture
Vaginal secretions, produced mainly by the cervix and glands near the vaginal opening, have several functions:
- they keep the tissues lubricated and make sex comfortable;
- they act as a barrier against infection;
- they help maintain an acidic environment, which supports healthy bacteria.
There is no “normal” amount. Healthy discharge is usually clear or whitish, without a strong smell, and does not cause itching or burning.
What is vaginal dryness?
Dryness occurs when the vagina produces less moisture than usual and its lining becomes thinner, less elastic and more fragile. It is most often linked to a fall in oestrogen. After menopause, these changes form part of what doctors call the genitourinary syndrome of menopause.
Common causes
- Menopause and perimenopause.
- Breastfeeding, because of hormonal changes after birth.
- Some hormonal contraceptives and medicines.
- Cancer treatments that affect the ovaries, and surgical removal of the ovaries.
- Irritation from soaps, douches and scented products.
Symptoms
- A feeling of dryness, tightness or burning.
- Pain or discomfort during sex.
- Itching or soreness.
- More frequent urinary infections or urgency.
Diagnosis
A doctor will ask about symptoms and medical history and carry out a gynaecological examination. They may check the vaginal pH and rule out other causes, such as infections or skin conditions.
Treatment
The choice depends on the severity of symptoms, the woman’s preferences and her medical history.
Non-hormonal options
- Vaginal moisturisers, used regularly several times a week.
- Water- or silicone-based lubricants during sex.
- Avoiding irritants such as perfumed soaps and douches.
Hormonal options
- Low-dose vaginal oestrogen, as cream, tablets or a ring, which acts locally with very little absorption.
- Vaginal DHEA (prasterone).
- Systemic hormone therapy, when there are other menopausal symptoms.
Other treatments
Some clinics offer vaginal laser, radiofrequency or plasma-based treatments. The evidence for these is still limited, and professional bodies recommend discussing their benefits and costs carefully with a specialist.
Self-care
- Regular sexual activity can help maintain blood flow to the tissues.
- Don’t smoke, as smoking can lower oestrogen levels.
- Wash with water or a mild, unscented cleanser.
When to see a doctor
Anyone with persistent dryness, pain during sex, itching or recurrent infections should talk to their GP or gynaecologist. It is a medical problem with effective solutions — not something to simply put up with.
