Patient education: Vaginal dryness (The Basics)

What is vaginal dryness? — 

This is when the vagina and vulva get dry, thin, and inflamed. (The vulva is the area around the vagina.) This can be uncomfortable or make sex painful. It happens when your body does not make enough of a hormone called estrogen.

Vaginal dryness is often related to menopause (when you stop having a monthly period). It can also happen if your ovaries were removed, if you take certain medicines, or if you are breastfeeding. Medical terms for vaginal dryness include "vaginal atrophy," "vulvovaginal atrophy," and "atrophic vaginitis." If your symptoms are related to menopause, your doctor might also use the term "genitourinary syndrome of menopause," or "GSM."

See your doctor or nurse if you have vaginal dryness or related symptoms that bother you. Some people are embarrassed to talk about this. But it is a common medical issue, and there are treatments that can help.

What other symptoms can happen? — 

Some people have other symptoms in addition to dryness. They can include:

●Vaginal burning or irritation

●Making less lubrication (wetness) during sex

●Pain during sex

●Bleeding when something touches or rubs the vagina, such as after sex

●Thin, white discharge from the vagina that does not smell bad

●Urinary problems, such as having to urinate often, having pain with urination, or leaking urine

What can I do on my own to feel better? — 

You might feel better if you use lubricants before sex and use a vaginal moisturizer several times a week. Vaginal moisturizers (sample brand names: Replens, K-Y SILK-E) are not the same as lubricants. They help keep the vagina moist all of the time, not just during sex.

You should also practice good hygiene for the vagina and vulva. This means avoiding bubble baths, douching, and using scented soaps or lotions in your genital area. These can cause dryness or irritation.

Can I still have sex? — 

Yes, if it is not uncomfortable. Regular sexual activity, with a partner or by yourself, can help to keep the tissues in your vagina more elastic. But if sex is uncomfortable or painful, see a doctor.

How is vaginal dryness treated? — 

The most effective treatment is the hormone estrogen. Doctors recommend "vaginal estrogen" for vaginal dryness. This means any form of estrogen that goes directly into the vagina. It comes in creams, tablets, or a flexible ring. Vaginal estrogen comes in small doses, so it does not increase the levels of estrogen in other parts of the body very much.

Estrogen also comes in higher doses. These come as a pill, skin patch, or different vaginal ring. These are sometimes called "hormone therapy." Vaginal estrogen is better for treating symptoms of vaginal dryness. But if you have other menopause symptoms, such as hot flashes or night sweats, higher-dose estrogen might be an option. Your doctor or nurse can talk to you about this. There are different risks and benefits, and some people cannot safely take high doses of hormones.

Besides estrogen, medicines that can treat vaginal dryness include:

●Ospemifene (brand name: Osphena) – This is similar to estrogen, but is not estrogen. It comes as a pill you take once a day. It can cause hot flashes.

●Prasterone – This is also called "DHEA." It is a medicine you put into your vagina once a day. It comes as a "suppository." This is similar to a tablet or pill but goes directly into the vagina.

Other treatments are also available, but are not used as often.

When should I call the doctor? — 

Call your doctor or nurse for advice if:

●Your symptoms are not getting better with treatment, or are getting worse.

●You have signs of a urinary tract infection – These might include a fever of 100.4°F (38°C) or higher, chills, pain or burning when urinating, or blood in your urine.

●You have vaginal discharge that is yellow or gray or has a bad smell.

●You have vaginal bleeding after sex.

More on this topic

Patient education: Dyspareunia (painful sex) (The Basics)
Patient education: Menopause (The Basics)
Patient education: Hormone therapy for menopause (The Basics)
Patient education: Bleeding after menopause (The Basics)
Patient education: Sex problems in females (The Basics)
Patient education: Vaginal discharge (The Basics)
Patient education: Vulvar pain (The Basics)
Patient education: Vulvar itching (The Basics)
Patient education: How to use vaginal medicines (The Basics)

Patient education: Menopause (Beyond the Basics)
Patient education: Vaginal dryness (Beyond the Basics)
Patient education: Menopausal hormone therapy (Beyond the Basics)
Patient education: Sexual problems in females (Beyond the Basics)
Patient education: Vaginal discharge in adult women (Beyond the Basics)