Vaginal dryness
Dryness, itching, soreness or discomfort during sex, sometimes with urinary symptoms.
What it feels like
Dryness, itching or soreness, discomfort or pain during sex, and sometimes urinary symptoms: needing to go more often, urgency, or repeated urine infections.
Up to half of women experience this after menopause, and it is significantly under-reported. Many women assume nothing can be done, which is not the case.
Why it happens
Lower oestrogen makes vaginal and urinary tissue thinner, drier and less elastic. Unlike hot flushes, these symptoms usually get worse over time without treatment rather than settling on their own.
What can help
- Vaginal oestrogen is very effective and can be used long term. Very little is absorbed into the body, so it can often be used alongside body-wide HRT, instead of HRT, or by some women for whom body-wide HRT is not suitable.
- Moisturisers and lubricants can be used on their own or alongside treatment.
- CO2 laser therapy (MonaLisa Touch) is an option for some women, particularly where oestrogen has not been enough or is not suitable. Your doctor will explain whether it is appropriate for you and what the evidence supports.
When to see a doctor
These symptoms are common and treatable, so there is no need to put up with them. Any bleeding after the menopause should always be checked promptly, as should pain that is new or severe.
If dryness is one of several symptoms, a personalised HRT plan can treat it alongside the others rather than on its own. Dryness often starts in perimenopause and, unlike flushes, tends to get worse rather than better without treatment. It is one of many symptoms of low oestrogen that also affects the skin elsewhere; see what HRT does for skin.
Often goes with vaginal dryness.
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Intimacy
Low libido
Less interest in sex, or less pleasure from it, than before.
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Body
Joint pain
Aching, stiff joints and muscles, often worse in the morning, without an obvious injury.
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Sleep & energy
Low energy
Tired on waking, flat by mid-afternoon, and less able to recover than you used to be.
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Questions about vaginal dryness, answered.
Is vaginal dryness part of menopause?
Yes. Falling oestrogen makes vaginal and urinary tissue thinner and drier. It affects up to half of women after menopause, and unlike hot flushes it usually gets worse over time rather than better.
Is vaginal oestrogen safe to use long term?
Very little is absorbed into the body, so it can usually be used long term. It can also often be used by women who cannot take body-wide HRT, though your doctor will check this against your history.
Can I use it alongside HRT?
Yes. Many women need both, because body-wide HRT does not always fully treat vaginal and urinary symptoms.
What if oestrogen has not been enough?
Non-hormonal moisturisers and lubricants help, and a CO2 laser treatment such as MonaLisa Touch is an option for some women. Your doctor will talk you through whether it is appropriate for you.
What if I bleed after the menopause?
Any bleeding after the menopause should be checked promptly by a doctor, even if you think it is dryness. It usually turns out to be harmless, but it needs assessing to rule out anything serious.
Hormones matter.
Let's treat them properly.
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