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What Causes Vaginal Dryness?

Written by

Lucy Abrams-Husso

Lucy Abrams-Husso is an artist and academic who has been working as a researcher for nearly 10 years. Her own experience starting a family motivated her to want to work towards providing others with easy-to-understand, factual, and empathetic resources on topics in women's health, particularly fertility, pregnancy, and postpartum. Lucy recently completed her doctorate degree at the Sibelius Academy of the University of the Arts Helsinki and is based in Helsinki, Finland.

Fact checked by

Maja Garbulinska

Maja Garbulinska holds Master’s in Health Data Science from Harvard University. Maja joined Natural Cycles driven by her passion for advancing female and reproductive health. She has several years of experience working with data science and machine learning in Swiss biotech industry.

, Scientist at Natural Cycles

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Last updated:

Jul 23, 2026

7 min read

Key takeaways

Vaginal dryness is a common condition that can affect women of all ages
The most common remedies include personal lubricant, if dryness is mainly an issue during sex, vaginal moisturizers, and hormonal treatments
If vaginal dryness is affecting your day-to-day life, it’s important to speak with your doctor or nurse for personal treatment advice

Discomfort down there can be a huge disruption to your day-to-day, and vaginal dryness might be to blame. Dryness can happen at any age, though it's most commonly linked to the major hormone-related shifts you experience through life from your menstrual cycle, postpartum, during perimenopause, and after menopause. In this article, we’ll talk about what causes vaginal dryness, what it feels like, and what treatment options are out there. We’ll also cover some frequently asked questions related to treatments and symptoms.

What is vaginal dryness?

When the vagina isn’t able to lubricate or moisten itself naturally, you can experience a condition called vaginal dryness. Vaginal dryness can happen at any age, but it’s most commonly associated with the symptoms of perimenopause and menopause.

The vagina doesn’t have a gland that continuously produces a moisturizing liquid or mucus. Instead, it stays naturally moist through normal, healthy blood flow. The pressure of blood flowing through the capillaries of the vagina pushes water and other small biological materials out from the gaps in between vaginal skin cells. Increased blood flow, like when you’re aroused, causes even more liquid to be released. [1]

The gas nitric oxide (NO), which your body naturally produces, helps relax blood vessels, allowing them to widen and improve blood flow throughout the body. Hormones like estrogen help the body make NO. Estrogen decline, which can occur naturally through the our menstrual cycles, postpartum, during perimenopause, and after menopause, can reduce your body’s ability to make NO and affects blood flow, thereby affecting moisture levels in the vagina. [1]

What does vaginal dryness feel like?

Vaginal dryness can be experienced differently by each of us. You might feel irritation, itchiness, or burning in your vagina throughout the day or feel pain or discomfort during sex. It’s also possible to suffer from other symptoms like unusual vaginal discharge, spotting or bleeding, feel the need to pee more often than usual, or you might start to get urinary tract infections (UTIs) more often. [2]

Vaginal dryness causes

Natural fluctuations in our hormones, certain prescription medications, chronic conditions like diabetes, and even some medical treatments are all linked to vaginal dryness. Even washing down there with some perfumed soaps, washes, or douches can cause dryness. [2]

The most common causes, however, have to do with estrogen fluctuations during our perimenopause and post-menopause and through our menstrual cycle. Let’s look at each in more detail.

Vaginal dryness during perimenopause and post-menopause

During perimenopause and afterward, at least 1 out of every 2 women experience a vaginal symptom like burning, irritation, dryness, incontinence, or increased UTIs associated with estrogen decline. It’s so common that doctors group these symptoms together and call it genitourinary syndrome of menopause, or GSM. It’s also sometimes called vulvovaginal atrophy or atrophic vaginitis (VVA). Unlike other symptoms of perimenopause, like hot flashes or night sweats, which can go away or lessen over time without treatment, GSM can stick around and even get worse after reaching menopause. For this reason, longer-term treatments for vaginal dryness experienced during perimenopause and post-menopause can be prescribed. [3]

Vaginal dryness and the menstrual cycle

During our hormone-driven menstrual cycle, estrogen levels fluctuate naturally. Estrogen increases during the follicular phase, which begins on the first day of your period, helping to thicken the uterine lining and prepare for the release of an egg cell during ovulation. Estrogen has a second, smaller peak during the luteal phase, but drops again before we get our period. When estrogen is at its lowest levels at the beginning and end of each cycle, it’s normal to experience vaginal dryness. Unlike GSM-related dryness, vaginal dryness during our menstrual cycle is considered temporary. [4]

Treating vaginal dryness

There are a number of different treatments for vaginal dryness, including personal lubricants, moisturizers, and hormone therapies. A pharmacist, nurse, or doctor can help you find the treatment that is best for you based on the underlying cause of your dryness and your individual health history.

Medical treatments

If you are experiencing vaginal dryness due to changes in your hormone levels caused by perimenopause, postmenopause, or another condition, you might be prescribed medicines to replace declining estrogen levels. These are known generally as hormone therapies (HT or HRT) and can come in pill, patch, gel, spray, cream, or implant form. [2,5]

While hormone therapies can help relieve a number of perimenopause symptoms, including vaginal dryness and protect against bone loss and osteoporosis, they are not recommended for everyone. If you have ever had breast or endometrial cancer or suffered from a stroke, heart attack, blood clots, or liver disease, some forms of systemic hormone therapy are not suitable, and your doctor will likely consider your medical history when prescribing such treatments. Hormone therapies are also not suitable for women who are pregnant or who are trying to become pregnant. [5,6,7]

Depending on your individual history, vaginal estrogen may need extra caution and a clinician’s review before use. You should check with a doctor or specialist nurse if you have had breast cancer, a blood clot, a heart attack, a stroke, angina, liver problems, or other conditions that could affect safety. However vaginal estrogen can still be considered for some people with a personal history of breast cancer if non-hormonal options have not helped. For example, depending on your medical history, vaginal estrogen may be considered after non-hormonal options have not helped, in discussion with a clinician. [6,7]

At-home treatments

Personal lubricants and moisturizers are effective for helping with discomfort caused by vaginal dryness and for helping make sex more enjoyable. Lubricants can be water-, silicone-, mineral oil-, or plant oil-based and are typically applied to the vagina and vulva, as well as to your partner’s genitals, before sex. Personal lubricants are generally recommended if you are noticing or bothered by vaginal dryness only during sex. [2,5,6]

Some vaginal moisturizers are also available over-the-counter. Instead of using them immediately before sex, vaginal moisturizers are usually applied regularly between one and three times per week. They work by sticking to the mucus-producing tissues in the vagina, hydrating the skin tissues, and improving vaginal hydration and helping support natural lubrication. Moisturizers are recommended for those with mild to moderate dryness and who are experiencing discomfort throughout the day, not only during intercourse. [2,5,8]

Vaginal dryness natural remedies

There are many plant and herbal supplements marketed to help with vaginal dryness and other perimenopause symptoms, including products containing soy, red clover, and black cohosh. However, there is limited scientific evidence that these products are safe or effective for treating vaginal dryness. Unlike prescription medicines, supplements are not evaluated through the same regulatory processes for safety, quality, and effectiveness before they are marketed. If you're considering using a herbal supplement or other complementary therapy, talk to your healthcare provider or pharmacist first. [5]

Vaginal dryness natural remedies

When to see a doctor

If you are suffering from vaginal dryness, or experiencing any other symptoms that concern you, it’s important to contact your nurse or doctor. While it’s possible to treat vaginal dryness during sex easily with personal lubricant, if you suspect your dryness is the result of perimenopause, a side effect to medication, or a medical condition, a healthcare professional can help diagnose the cause and recommend the most effective treatment.

Navigating perimenopause with Natural Cycles

NCº Perimenopause is the latest addition to Natural Cycles, developed to support you through the physical and cognitive changes you might experience in the journey towards and beyond menopause. Perimenopause is individual, which can make it difficult to understand where you are along the journey and what to expect. Tracking symptoms and lifestyle factors in NCº Perimenopause can help you learn more about your body and inform discussions with your doctor as you make a treatment plan Whether it’s just vaginal dryness, or other symptoms, why not see if Natural Cycles can help you understand your menopausal shift better today?

1. Wilhite M. Vaginal dryness. In: Elsevier eBooks [Internet]. 2017. p. 592-599.e2. Available from: https://doi.org/10.1016/b978-0-323-35868-2.00059-1

2. Vaginal dryness [Internet]. nhs.uk. 2025 [Cited 13 Jul 2026]. Available from: https://www.nhs.uk/symptoms/vaginal-dryness/

3. Ulhe SC, Acharya N, Vats A, Singh A. Study of Vulvovaginal Atrophy and Genitourinary Syndrome of Menopause and Its Impact on the Quality of Life of Postmenopausal Women in Central India. Cureus. 2024 Feb 24;16(2):e54802. doi: 10.7759/cureus.54802. PMID: 38529421; PMCID: PMC10961929.

4. Reed BG, Carr BR. The Normal Menstrual Cycle and the Control of Ovulation. [Updated 2018 Aug 5]. In: Feingold KR, Adler RA, Ahmed SF, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279054/

5. Hormone therapy for menopause [Internet]. ACOG. [Cited 14 Jul 2026]. Available from: https://www.acog.org/womens-health/faqs/hormone-therapy-for-menopause

6. About vaginal oestrogen [Internet]. nhs.uk. 2026 [Cited 16 Jul 2026]. Available from: https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/vaginal-oestrogen/about-vaginal-oestrogen/

7. Who can and cannot use vaginal oestrogen [Internet]. nhs.uk. 2026 [Cited 16 Jul 2026]. Available from: https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/vaginal-oestrogen/who-can-and-cannot-use-vaginal-oestrogen/

8. Sarmento ACA, Kamilos MF, Costa APF, Vieira-Baptista P, Eleutério J Jr, Gonçalves AK. Use of Moisturizers and Lubricants for Vulvovaginal Atrophy. Front Reprod Health. 2021 Dec 23;3:781353. doi: 10.3389/frph.2021.781353. PMID: 36303977; PMCID: PMC9580673.

9. Sites CK. Bioidentical hormones for menopausal therapy. Womens Health (Lond). 2008 Mar;4(2):163-71. doi: 10.2217/17455057.4.2.163. PMID: 19072518.

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Frequently asked questions

There are a number of possible treatments for vaginal dryness, and choosing the right one for you can depend on the timing and severity of your symptoms. If you are suffering from periodic dryness due to the hormonal fluctuations of your menstrual cycle or as a side effect from a temporary medication, you might find that personal lubricants can make sex more enjoyable and over-the-counter vaginal moisturizers can relieve your symptoms day-to-day. However, if you suspect you’re going through perimenopause or if dryness is not going away or getting worse, it might be worth discussing other treatments, like hormone therapies, with your doctor.

When you are sexually aroused, increased blood flow in and around your vagina usually helps to increase the amount of lubricating fluid your vagina produces. However, a reduction in the hormone estrogen due to your monthly cycle, perimenopause, or another factor or condition can limit blood flow and reduce the amount of moisture down there, whether you are feeling in the mood or not. This disconnect between mind and body can be frustrating, particularly if it comes at a time when your body is going through a number of changes.

If you are experiencing vaginal dryness during intercourse, it’s a good idea to use a personal lubricant to make sex as comfortable and pleasurable as possible. If you suspect the dryness might be linked to perimenopause, a side effect to medication, or a medical condition, speak to your doctor or nurse about other possible treatments.

Depending on the cause of your vaginal dryness, prescription treatments are available. If your symptoms are related to perimenopause or menopause, your healthcare provider may recommend local hormone therapy, such as vaginal estrogen, which is often the most effective treatment. In some cases, oral prescription medications may also be an option. Your healthcare provider can help determine which treatment is most appropriate based on your symptoms and medical history. [5].

There are many vaginal moisturizers available to help relieve vaginal dryness. Most are available over the counter and come in a variety of formulations, including gels and creams. They are typically used regularly — rather than just before sex — to help hydrate the vaginal tissues.

If over-the-counter moisturizers don't provide enough relief, your healthcare provider may recommend a prescription local hormone therapy, such as a vaginal cream, tablet (pessary), or ring. For advice on choosing the right product, speak with your pharmacist, nurse, or healthcare provider.