How to recognise the signs of vaginal dryness and effective remedies to help alleviate discomfort

It’s no secret that as we age, our bodies go through a vast array of changes. For women, vaginal dryness is one of these changes. It’s a subtle sign that no one else will notice, but one that you can definitely feel.

Vaginal dryness is common for women over the age of 45, with studies finding almost one in two women suffer from the condition. Not only does vaginal dryness cause general everyday discomfort, but the pain can become intense, affecting your sex life by making it an agonising and unpleasant experience, and reducing your overall quality of life.

As normal as it is, many women are reluctant to discuss vaginal discomfort, often putting off treatment. There’s no need for you to suffer through vaginal dryness, so Starts at 60 has put together the information you need to help combat and relieve the discomfort from the condition – including some effective medical treatments that are widely recommended but not always well known.

What are the symptoms of vaginal dryness?

You’ll likely know if you’re suffering from vaginal dryness; the discomfort from the lack of natural lubrication of the vaginal tissue can feel overwhelming. However, there are specific warning signs and symptoms.

The signs and symptoms can include:

• soreness, itching or burning in the genital region
• pain or discomfort during sexual intercourse
• light bleeding after intercourse
• mild vaginal discharge
• increased urinary urgency, or more frequent urinary tract infections

That last symptom is worth paying attention to. Doctors now recognise that vaginal dryness rarely occurs in isolation after menopause – it’s typically part of a broader set of changes affecting the vagina, vulva and bladder, known as Genitourinary Syndrome of Menopause (GSM). Understanding it as part of this bigger picture can help explain why some women also notice more frequent UTIs or bladder irritation alongside dryness.

Pain and discomfort such as itching, burning and soreness during intercourse can be linked to other conditions such as:

• sexually transmitted infections and diseases
• vaginitis
• low estrogen levels
• lichen sclerosis (a postmenopausal condition causing scaly and inflamed genitals)
• genital injury

It’s important to see a doctor if you’re experiencing any of these symptoms.

Why do I have vaginal dryness?

Vaginal dryness is most commonly linked to a drop in estrogen levels. Although these hormonal changes can happen at different moments throughout a woman’s life (childbirth and breastfeeding), menopause is the usual culprit for ageing women.

The drop in estrogen levels leads to internal and external vaginal skin thinning, becoming dry and sensitive.

Other influencing factors in vaginal dryness can include certain medications, smoking and drinking alcohol.

It’s also worth knowing that GSM is typically progressive – meaning it tends to gradually worsen over time if left untreated, rather than resolving on its own. This is one of the key reasons current medical guidelines encourage women not to simply “wait it out.”

Similar to dry hands and lips, your intimate area needs to be targeted to revitalise the area, bringing back the much-needed moisture.

How can I treat vaginal dryness?

There are a variety of ways to treat vaginal dryness, from over-the-counter moisturisers and lifestyle changes through to prescription medical treatments. Reintroducing moisture can bring immediate relief to any pain and discomfort you may be suffering in your nether region. These options can help bring back your quality of life and reinvigorate your sex life.

Vaginal moisturisers

Unlike lubricants, which sit on the skin’s surface, vaginal moisturisers are absorbed into the skin’s barriers. Vaginal moisturisers keep moisture in your skin’s delicate tissue, which can help alleviate itching and irritation. If used regularly, vaginal moisturisers can help keep your vaginal tissues supple and less prone to tearing.

There are many types of vaginal moisturisers on the market. Some are gel-based while others are creams, and they can also come with an applicator if you prefer not to use your clean hands. In recent years, moisturisers containing hyaluronic acid have become increasingly popular and are commonly recommended alongside more traditional options, thanks to their ability to draw and retain moisture in the tissue.

Vaginal moisturisers are readily available over the counter, and since they don’t contain hormones, you don’t need a prescription to buy one.

Tips on using vaginal moisturisers:

• Consider applying the vaginal moisturiser 3 to 5 times a week. However, if that doesn’t feel like it’s enough, feel free to use it more often.
• Ensure you’re applying the vaginal moisturiser outside the vulva area to ease any dryness or irritation.
• It’s recommended to apply your moisturiser at night, to allow the product to be properly absorbed into your skin without running the risk of leaking.

Medical and prescription treatments

For moderate to severe dryness, or symptoms that aren’t well controlled by moisturisers alone, several prescription treatments are now considered first-line options by major international menopause and urology societies. These are worth raising with your GP or gynaecologist if over-the-counter options haven’t given you enough relief.

Low-dose vaginal estrogen – applied directly as a cream, tablet or ring inserted into the vagina, this delivers a small, localised dose of estrogen to restore thickness and lubrication to vaginal tissue, with only minimal absorption into the rest of the body. It’s regarded by current guidelines as the most effective and well-studied treatment for moderate to severe symptoms, and has also been shown to reduce the frequency of recurrent UTIs in women with GSM.

Vaginal DHEA – a hormone-based suppository inserted nightly, which has been shown in clinical trials to improve dryness and painful intercourse. It’s a useful alternative for women who prefer not to use estrogen directly.

Ospemifene – a non-hormonal tablet taken by mouth, used specifically to treat pain during intercourse caused by vaginal tissue thinning. This can be a helpful option for women who aren’t suitable candidates for hormonal treatments.

A note for women with a history of breast cancer: many women assume a breast cancer history automatically rules out any of these treatments, but current guidelines suggest low-dose vaginal estrogen and vaginal DHEA can still be considered for some women in this situation, under medical supervision. This is a conversation worth having directly with your treating specialist rather than ruling it out yourself.

Natural remedies

Vaginal dryness can also be treated with natural remedies like keeping hydrated. Water is a natural lubricant, and not keeping hydrated can perpetuate the dry condition. Eating foods that include plant estrogen, such as soybeans, flaxseed, berries and dried fruits, may also support the lubrication of your nether region.

Lifestyle changes

Increasing blood flow through regular exercise can help bring balance back moisture to your intimate region by stabilising hormone levels. Sex is also a good way to cause blood flow and stimulate moisture directly to the area.

To avoid worsening the symptoms of vaginal dryness, it is important to seek treatment — and to know that effective, low-risk medical options exist beyond the moisturisers and lifestyle changes most women try first.

IMPORTANT LEGAL INFO: This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.