SEXUAL HEALTH CONCERN

Vaginal Dryness

Also called: vaginal dryness, dry down there, dryness during sex

Vaginal dryness occurs when vaginal tissues have less natural moisture and lubrication than usual. It can cause irritation, burning, itching or discomfort during sex and can occur at any age, although it is particularly common during and after menopause.

TYPICALLY OCCURS

Low oestrogen, menopause, medication and hormonal changes

TREATED BY

Hormonal therapy, vaginal moisturisers and lubricants

ALSO LINKED TO

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Why it happens?

Oestrogen plays an important role in maintaining the thickness, elasticity, blood flow and natural moisture of vaginal tissues. When oestrogen levels decline, these tissues can become thinner, drier and less elastic, while natural lubrication may decrease. This is particularly common during perimenopause and after menopause and forms part of a group of changes known as genitourinary syndrome of menopause (GSM). Unlike some other menopause symptoms, vaginal dryness does not necessarily improve with time and can become more noticeable without appropriate management.

Lower oestrogen levels can also occur at other stages of life. Vaginal dryness may develop after childbirth or during breastfeeding and can occur following surgical removal of the ovaries or certain cancer treatments. Some medications, including particular hormonal treatments, may contribute. Natural lubrication is also influenced by sexual arousal, so insufficient arousal, stress, anxiety or sexual difficulties can sometimes cause or worsen dryness during sexual activity even when hormone levels are not the primary issue.

Not every sensation of vaginal dryness is caused by hormones. Fragranced soaps, intimate washes, douches and other irritating products can disrupt or irritate sensitive vulval and vaginal tissues. Infections and certain vulval or dermatological conditions can cause burning, itching and soreness that may be mistaken for simple dryness. Persistent dryness can also make vaginal tissues more vulnerable to irritation and small tears, potentially causing pain during sex or light bleeding afterwards. Identifying whether symptoms are hormonal, medication-related, irritant-related or due to another condition is therefore important when they persist.

How far along is it?

Early

Dryness or reduced lubrication occurs occasionally, particularly during sexual activity. There may be mild irritation, sensitivity or discomfort.

Moderate

Dryness becomes more frequent and may be accompanied by burning, itching, soreness or discomfort during penetration. Vaginal tissues may feel increasingly sensitive.

Advanced

Dryness and tissue changes cause persistent discomfort, painful sex or recurring irritation. Urinary symptoms or light bleeding related to fragile tissues may also occur, particularly when symptoms are associated with menopause.

What addresses it?

Treatments that address this

Women's sexual health→Female hormone checkup→

Professional advice is worthwhile when vaginal dryness persists, repeatedly causes discomfort or begins affecting sexual activity or everyday wellbeing. It is particularly useful to seek assessment when dryness occurs alongside significant burning, itching, pain during sex or urinary symptoms.

Medical assessment is also important when symptoms are new or unexplained, as infections and vulval skin conditions can sometimes produce similar symptoms. Persistent symptoms should not automatically be assumed to be caused by menopause.

Bleeding after menopause should always be medically assessed, even when it occurs after sexual activity and appears to be related to dryness. Repeated bleeding after sex, unusual discharge, sores, significant pelvic pain or noticeable changes to the vulval skin should also be discussed with a healthcare professional.

Quick Questions:

What is the most common cause of vaginal dryness?

Hormonal changes, particularly declining oestrogen during perimenopause and after menopause, are a common cause. However, breastfeeding, medications, insufficient sexual arousal and irritation can also contribute.

Can vaginal dryness cause painful sex?

Yes. Reduced natural lubrication increases friction during sexual activity and can cause burning, soreness or pain. Thinner or less elastic vaginal tissues associated with lower oestrogen can further contribute to discomfort.

Can vaginal dryness happen before menopause?

Yes. It can occur at any age. Breastfeeding, childbirth-related hormonal changes, certain medications, cancer treatments, stress and insufficient sexual arousal are among the possible causes before menopause.

Does vaginal dryness go away on its own?

It depends on the cause. Temporary dryness associated with short-term hormonal or lifestyle changes may improve, while menopause-related vaginal dryness can persist or become more noticeable. Ongoing symptoms are worth discussing with a healthcare professional to identify the cause and appropriate options.