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Vaginal dryness
Category: Women's Health · All women's health symptoms
What it can feel like
Vaginal dryness means the vaginal tissues produce less natural moisture and become thinner and less elastic — causing dryness, soreness, itching, stinging on passing urine, and pain during sex. It is most strongly linked to falling oestrogen at the menopause but has other chapters too.
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
Dryness can be associated with the menopause and perimenopause, breastfeeding, hormonal contraception, medicines such as antihistamines and some antidepressants, and insufficient arousal time — a normal physiological factor often overlooked.
Other possible causes
Persistent dryness can be associated with genitourinary syndrome of menopause (progressive without treatment, unlike hot flushes), Sjögren's syndrome, skin conditions such as lichen sclerosus, and the effects of chemotherapy or pelvic radiotherapy.
Red flags — when to seek help promptly
- Dryness with bleeding after sex or postmenopausal bleeding
- Dryness with recurrent urine infections
- Dryness with vulval skin changes — white patches, splitting, or a sore that does not heal
- Dryness with severe pain that is not improving with moisturisers
What a clinician may do
A clinician will examine the tissues, review medicines and menopause status, and distinguish dryness from infection or skin disease. Treatment is stepwise: regular vaginal moisturisers and lubricants, low-dose vaginal oestrogen where appropriate (minimal absorption), and specific treatment for any skin condition found.
Related guides on MedicalVideos.com
Frequently asked questions
Do vaginal moisturisers and lubricants do the same job?
No — moisturisers are used regularly (like hand cream) to rehydrate tissue over time; lubricants are used at the moment, for sex. Many people need both. Neither replaces oestrogen where tissue thinning is the driver, which is when low-dose vaginal oestrogen enters the discussion.
Is vaginal oestrogen safe if I avoid HRT tablets?
Low-dose vaginal oestrogen acts locally with minimal absorption into the bloodstream and is generally considered a different risk category from systemic HRT. It is usually suitable even for many women who cannot take systemic HRT, but the decision is individualised — your clinician will take your history into account.
Related symptoms — Women's Health
Browse the V section of the A–Z list or return to the Symptoms A–Z hub.