It's one of the least talked-about symptoms of perimenopause and menopause, and one of the most treatable. Vaginal dryness, soreness, itching, or discomfort and pain during sex affects a huge number of women, yet most suffer in silence because it feels awkward to raise. You don't have to, and you shouldn't.
Why menopause causes vaginal dryness
The tissues of the vagina, vulva and bladder rely on oestrogen to stay thick, elastic, lubricated and resilient. As oestrogen falls in perimenopause and after menopause, those tissues become thinner, drier and more easily irritated. Doctors call this collection of symptoms the genitourinary syndrome of the menopause (GSM). Unlike hot flushes, which usually ease over time, GSM tends to persist or worsen without treatment, which is exactly why it's worth acting on.
What it can look like
- •Dryness, itching, burning or general soreness
- •Discomfort or pain during sex, and less natural lubrication
- •Needing to wee more often, urgency, or recurrent urinary or bladder infections
- •Irritation from things that never bothered you before (soap, tight clothes)
What can help
This is a symptom with genuinely effective options, and both the NHS and British Menopause Society (BMS) recognise it as worth treating:
- •Vaginal moisturisers (used regularly) and lubricants (used for sex) are available over the counter and help many women
- •Avoid perfumed soaps, shower gels and wipes on the vulva, which make irritation worse
- •Vaginal (local) oestrogen, a low-dose tablet, cream, gel or ring a GP or nurse prescriber can prescribe, works directly on the tissues; the BMS notes it can be used long term and by many women who can't or don't want to take whole-body HRT
- •Because GSM tends not to resolve on its own, it usually needs ongoing rather than one-off treatment
You don't have to choose between putting up with it and having an awkward conversation. It is a common, recognised medical issue, and the treatments are straightforward. Whether local oestrogen or another option is right for you is a decision to make with a GP or nurse prescriber.
Not sure if it's perimenopause?
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Frequently asked questions
Is vaginal dryness a symptom of menopause?
Yes. Falling oestrogen thins and dries the vaginal and vulval tissues, causing dryness, irritation and discomfort. Along with related bladder symptoms it's known as the genitourinary syndrome of the menopause (GSM).
Does menopause vaginal dryness go away on its own?
Usually not. Unlike hot flushes, GSM tends to persist or get worse over time without treatment, which is why it's worth addressing rather than putting up with.
What is the best treatment for vaginal dryness in menopause?
Over-the-counter vaginal moisturisers and lubricants help many women. For more persistent symptoms, a GP or nurse prescriber can prescribe low-dose vaginal (local) oestrogen, which the British Menopause Society notes works directly on the tissues and can be used long term. What's right for you is a decision to make with a clinician.
Can I use vaginal oestrogen if I can't take HRT?
Often yes. The BMS notes that low-dose vaginal oestrogen acts locally and can be suitable for many women who can't or choose not to take whole-body HRT, but this should always be decided with a clinician based on your own history.
When should I see a GP about vaginal dryness?
See your GP or a nurse prescriber if dryness, discomfort or pain is affecting your daily life or sex, or if you have recurrent urinary infections. Also get any unusual bleeding, discharge or persistent soreness checked to rule out other causes.
