Vaginal dryness is a common issue, particularly during and after menopause, but it can occur at any age. Characterized by a lack of moisture in the vaginal area, it can lead to discomfort, pain during intercourse, and an increased risk of vaginal infections. While it can be an embarrassing topic, understanding the causes, symptoms, and management strategies is crucial for maintaining vaginal health and overall well-being.
Understanding Vaginal Dryness
Vaginal dryness usually results from a drop in estrogen levels. Estrogen is the hormone that keeps the tissues lining the vagina thick, moisturized, and healthy. As levels decline, the lining becomes thinner, drier, and less elastic. These changes are known as vaginal atrophy.
Causes of Vaginal Dryness
Vaginal dryness usually results from low estrogen levels. Estrogen is the hormone that keeps the lining of the vagina lubricated, thick, and elastic. Estrogen levels begin to decrease as menopause approaches.
The ovaries produce estrogen, which controls the development of female body characteristics such as breasts and body shape. It also plays a key role in the menstrual cycle and pregnancy.
Estrogen helps keep the tissues lining the vagina thick, moisturized, and healthy. As levels decline, the lining becomes thinner, drier, and less elastic. These changes are known as vaginal atrophy.
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Estrogen levels can drop for various reasons, including:
- Menopause
- Surgical removal of the ovaries, which can trigger menopause
- Childbirth and breastfeeding
- Treatments for cancer, including chemotherapy and radiation
- Anti-estrogen drugs for treating breast cancer or endometriosis
Other potential causes of vaginal dryness can include:
- Sjögren’s syndrome, an autoimmune disorder that involves inflammation of the salivary and tear glands
- Antihistamines
- Antidepressants
- Stress and anxiety
- Reduced blood supply to the vagina
- Dehydration
- Flammer syndrome, in which blood vessels react in an unusual way to stimuli such as cold and stress
People who smoke or experience indoor air pollution may experience menopause earlier than those who do not, and so vaginal dryness may occur at an earlier age in this group.
Symptoms of Vaginal Dryness
Vaginal dryness can lead to pain during intercourse, contributing to a loss of sexual desire. It can also cause discomfort during sports and other physical activities and increase the risk of vaginal infections.
People should seek medical advice if they experience the following symptoms or other signs of change in their vaginal health:
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- Burning
- Itching
- Dryness
- Intercourse pain
- Irritation
Diagnosis
No single test can diagnose vaginal atrophy and vaginal dryness. A doctor will usually base the diagnosis on a person’s symptoms.
The doctor will likely:
- Ask about vaginal and other symptoms
- Ask about menstrual changes
- Do a pelvic examination
- In some cases, take a swab for a lab test
It might feel embarrassing and uncomfortable to discuss such personal details, but doctors are used to having these types of conversations. Seeking help is the first step toward managing symptoms.
Dietary Changes for Vaginal Dryness
Eating for vaginal skin health should follow the same principles that you would apply for the skin on your face and the rest of your body. A well-balanced diet is essential for maintaining vaginal and overall health. Certain menu items may help support healthier vaginal tissue and enhanced lubrication, which could improve symptoms like vaginal dryness, irritation, burning, or painful sex.
- Vitamin C-Rich Foods: Start by doubling your intake of vegetables, because these are a brilliant source of vitamin C. A red pepper contains about twice as much vitamin C per 100g as an orange, and broccoli, cabbage, kale and other leafy greens are all great options too. Eating plenty of foods rich in vitamin C is essential, because the body uses it to produce collagen, which keeps your skin strong and healthy.
- Foods Containing Isoflavones (Phytoestrogens): Eat foods containing isoflavones (phytoestrogens) to boost your body’s oestrogen production. Some research suggests that they may help to relieve vaginal dryness. Opting for fermented soya products like miso, tempeh or natto is likely to be more beneficial than processed soya products like milk or yoghurt. Eat more: soya products, soybeans, soy milk, soy yoghurt, miso soup. Also found in lower quantities in apples, cherries, peas, pulses, beans and multi-grain bread.
- Foods Containing Lignans (Phytoestrogens): Eat foods containing lignans (phytoestrogens) found in milled linseeds, whole grains, fruit, vegetables and legumes.
- Omega-3 Fatty Acids: Incorporating this versatile superfood into your diet may also help to improve symptoms of vaginal dryness, mainly because it’s rich in healthy fats, which have been shown to keep the skin nourished. Essential fatty acids play a key role here, because they act as natural lubricants and support the integrity of our cell membranes, ensuring that they retain the water which keeps them plump and elastic.
- Sweet Potatoes: These orange tubers are packed with beta-carotene, a precursor to vitamin A that the body needs to maintain healthy mucous membranes, which includes vaginal tissue. Rich in beta carotene and vitamin A, sweet potatoes help keep your mucous membranes healthy. This includes your vaginal tissues.
- Leafy Green Vegetables: It may be beneficial to say ‘yes' to that side of garlicky sauteed spinach or using baby kale as the base of a salad. Like sweet potatoes, leafy green vegetables are loaded with beta-carotene, as well as antioxidants that your body needs to support healthy vaginal tissue. These are packed with dietary nitrates, which help promote healthy circulation and tissue integrity. The beneficial properties of leafy greens can help maintain vaginal moisture and reduce dryness.
- Avocados: Avocados are rich in healthy fats, vitamin B6, and potassium, all of which can positively affect your overall libido and natural lubrication. Known for their healthy fats, avocados are rich in vitamins C and E, which may help improve vaginal lubrication and strengthen vaginal walls.
- Yogurt: Probiotic-rich food that contains certain Lactobacillus strains can help prevent the overgrowth of harmful bacteria. Although this benefit is often associated with gut health, it can also promote overall vaginal health. Probiotic-rich yogurt can help maintain a healthy vaginal pH, potentially preventing infections that can lead to dryness and irritation.
- Cranberry Juice: Pure cranberry juice and concentrated cranberry extract capsules are full of antioxidants and acidic compounds, which are powerful infection fighters that can help prevent bacteria from adhering to the bladder wall. Studies show that 100% cranberry products may be especially beneficial in preventing UTIs among people prone to recurrent infections. Unsweetened cranberry juice is often recommended for maintaining vaginal pH balance and reducing irritation.
- Water: Our skin needs plenty of water to retain its elasticity and our vaginal tissues are no exception. If they’re deprived of water, this will contribute to the atrophy (shrinking) that causes the dryness and itching that can be so uncomfortable. The amount of water we need will vary, depending on age, build, level of physical activity and the temperature of the environment, but the equivalent of about 6-8 glasses of water is probably about right for most people. Drink plenty of water which will ensure the vagina stays well lubricated and help prevent urinary tract infections.
Foods to Limit or Avoid
The general rule is to limit foods with added sugars and trans fats, as well as ultra-processed foods.
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- Sugar: We all know that eating too much sugar isn’t good for us, but here’s another great reason to help you step away from that bar of chocolate! Refined sugar is horribly ageing for the skin. In excess it can lead to a process called glycation which degrades the collagen in our tissues and causes the skin to become slack and wrinkly. Avoid meats and dairy products with artificial hormones, which can disrupt this protective lining. High sugar diets can kill off the good bacteria, causing an imbalance which leads to vaginal yeast or bacterial infections.
Lifestyle Changes for Vaginal Dryness
The following lifestyle changes can help combat vaginal dryness and discomfort.
- Stay Hydrated: Dehydration can lead to vaginal dryness. Drinking six to eight glasses of water daily, and potentially more in hot weather or when exercising, may help prevent vaginal dryness.
- Regular Sex: Regular sexual activity, whether alone or with a partner, can help manage vaginal dryness. Blood flow to the vaginal tissues increases during arousal, and this helps stimulate moisture production.
- Avoid Fragrances: The vagina contains a delicate balance of good bacteria and is self-cleaning. There is no need for douching or using fragrant soaps around the sensitive vaginal area; these may cause irritation or dryness. Choosing vaginal products without perfumes, herbal extracts, or artificial colors can minimize the risk of allergic reactions and irritation, helping to keep the area healthy.
- Prioritizing Sleep: Good sleep quality supports hormonal balance and overall health, which can alleviate symptoms of vaginal irritation.
- Practicing Pelvic Floor Therapy: Strengthening the pelvic muscles through exercises can enhance overall vaginal function and health, improving comfort during daily activities and intimacy.
Other Remedies for Vaginal Dryness
Over-the-Counter Treatments
Over-the-counter treatments may help with vaginal dryness.
For example, people can use artificial lubricants during intercourse to increase moisture. People can also use vaginal moisturizers daily or several times a week to help maintain the vagina’s natural moisture.
Local Estrogen Treatments
Local estrogen treatments are treatments that a person applies directly to the vagina. Doctors will consider topical estrogen therapies before oral estrogen for people with vaginal atrophy.
Examples include:
- Vaginal ring (Estring): The person inserts a flexible ring into the vagina where it continually releases low amounts of estrogen into the tissues. The person should replace the ring every 90 days.
- Vaginal cream (Estrace, Premarin): People may use an applicator to apply the cream into the vagina. Doctors may also recommend gel or spray products.
- Vaginal tablet (Vagifem): The person will use an applicator to place a tablet into the vagina.
People with a history of breast cancer, who are or may be pregnant, or who are breastfeeding should talk with their doctor about the safety of topical estrogen therapy. The doctor may recommend nonhormonal treatments instead.
Natural Remedies
- Coconut Oil: Coconut oil is a popular natural remedy for vaginal dryness, thanks to its moisturizing and soothing properties. It’s a safe, chemical-free option that can be used as a lubricant during sex to reduce friction and discomfort. To use coconut oil, apply a small amount to the vaginal area as needed. It’s important to note that while coconut oil is safe for topical use, it should not be used with latex condoms, as it can break down latex, increasing the risk of condom failure.
- Aloe Vera: Aloe vera is known for its skin-soothing properties, but it can also be beneficial for vaginal dryness. Aloe vera gel has hydrating and anti-inflammatory effects that may help to soothe irritated vaginal tissues, reduce dryness, and promote healing. A 2021 study found aloe vera to be effective for postmenopausal women, and it was found to be as effective as estrogen vaginal cream. You can use aloe vera gel both internally and externally, but it’s important to ensure the product you use is free from fragrances or chemicals that could irritate the sensitive vaginal area. To use aloe vera for vaginal dryness, apply a small amount of pure aloe vera gel to the outer vaginal area or insert it gently into the vagina, making sure to follow any specific instructions on the product label. Consult with your doctor if you’re considering internal use.
- Vitamin E: Vitamin E is another natural remedy known for its ability to hydrate and soothe dry tissues. It can help improve skin elasticity and moisture retention, making it a good option for alleviating vaginal dryness. Vitamin E is available in both oral supplements and topical oils. When used topically, vitamin E oil can be gently applied to the vaginal area to improve moisture and reduce irritation. Be sure to consult with your doctor before starting a new supplement regimen.
- Sea Buckthorn Oil: Sea Buckthorn Oil (containing Omega 3, 6 & 7) Buckthorn is a sea moss taken orally in capsules, or as a powder to add to smoothies, may increase vaginal PH and moisture.
- Ginseng: Ginseng is a phytoestrogenic herb that mimics the role of oestrogen, it may help with dryness and boost your energy.
- Sage: Sage is a natural hormone-mimicking supplement, thought to be a mild phytoestrogen.
When to Seek Medical Advice
People can speak with a trusted healthcare professional if they experience vaginal dryness. It is still a good idea to speak with a healthcare professional if someone experiences vaginal dryness. They can diagnose potential underlying health issues and approve any home management strategies a person wants to try.