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Vaginal dryness: Why it happens and what you can do about it

Tips, reasons and remedies for vaginal lubrication

Top things to know about vaginal dryness:

  • Vaginal dryness can have physical and psychological causes

  • Vaginal lubrication is often closely tied to levels of the hormone estrogen, which changes at various life stages

  • Medications (including hormonal birth control) may cause vaginal dryness

  • You can have a fulfilling sex life even if you don’t produce much natural vaginal lubrication

Vaginal dryness is common but treatable. It can happen at any age. Symptoms may include a burning sensation, vaginal discomfort or itching, atypical vaginal discharge, or pain during sex or masturbation (1).

Stress, depression, anxiety, and some medications, can affect sexual desire and hormones (2,3). Age and life stages also impact the body (1). Hormonal changes can cause the vaginal lining to become thin and dry (1,4). Emotions and desire can affect when and how much arousal fluid your body makes (5). Some people may experience mild discomfort with these changes. Others may experience extreme pain. Let’s take a deeper look at the causes and solutions.

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Why is my vagina dry? Common causes of vaginal dryness

Estrogen levels

The hormone estrogen helps keep the vagina moist and maintains the thickness of the vaginal lining. When this hormone is low, it can cause dryness, itching, pain, and discomfort during sex (1). This is known as atrophic vaginitis or vaginal atrophy.  

Your body produces less estrogen:

  • After having a baby, particularly if you’re breastfeeding

  • When taking medications that interfere with reproductive hormone regulation 

  • At the time of menopause 

    • During menopause, some people will experience vaginal and urinary changes from having low estrogen. They may have vaginal dryness and discomfort, need to pee often, cannot stop a sudden urge to pee (incontinence), get urinary tract infections (UTI) often, and their labia may get smaller. This is called genitourinary syndrome of menopause (GSM).

  • After removal of the ovaries, chemotherapy, or radiation therapy of the pelvis (1,4,6-8)

Medications

Hormonal birth control can impact the amount of hormones (estrogen and progesterone) in your body (9). These changes could cause vaginal dryness and decreased sexual desire in some individuals, but research shows mixed results (2,10,11). Before starting hormonal birth control, consider talking with your healthcare provider if you experience pain during sex or have low libido (9). You may benefit from trying another method of birth control if you feel that your current method is affecting your vaginal health (10). Antidepressants, antipsychotics, and antihistamines (including asthma and heart medications) can also impact vaginal dryness (2,11). 

Talk to your healthcare provider to find out if the source of your vaginal dryness could be your medication or contraception (12). 

Emotions and sexual desire

There are several reasons why you might notice dryness during vaginal sex. Are you turned on by what your partner is doing? If not, open communication is key. What needs to change to make sex more enjoyable for you? 

If you feel turned on but are still dry, your body may simply need time to catch up with your brain. Talk with your partner about increasing the amount of foreplay. If you have vaginal dryness and lack of sexual desire, you may be experiencing low libido. This can be caused by many factors, including medication and health conditions (9,11). 

Menstrual cycle hormonal fluctuations

The hormones estrogen and progesterone fluctuate throughout your menstrual cycle. Vaginal dryness may increase when estrogen levels are lower (5). These hormones can also affect sexual desire. Sexual desire can increase leading up to ovulation and lessen when more progesterone is produced during the luteal phase—the days after ovulation and leading up to menstruation (5). Exactly how reproductive hormones influence the vagina and sex drive isn’t the same for everyone (13). A tracking app like Clue can help you discover what’s typical for you.

Allergies and health factors

An allergy to chemicals in soap, detergent, lubricant, or hygiene products can impact your vagina. Your vagina is self-cleaning, so there is no need to use any internal washes (douches) or vaginal deodorants—in fact, they can be harmful. Research has linked the practice of douching with an increased risk of bacterial and yeast infections, pelvic inflammatory disease, cervical cancer, increased transmission of sexually transmitted infections (STIs), upper genital tract infections, endometritis (inflammation of the lining of the uterus), and other adverse health outcomes (14,15).

Cigarette smokers have an increased risk of an earlier menopause transition compared to non-smokers. This means that low estrogen vaginal symptoms may appear at a younger age in this population (6).

Sjögren’s syndrome is an autoimmune disease where the body’s glands cannot produce enough moisture (16). People with this syndrome have a higher risk of experiencing vaginal dryness after age 40.

What can I do about vaginal dryness?

Treatments for vaginal dryness

  • Vaginal dryness caused by low estrogen levels is treated by several different options: vaginal moisturizers or lubricants, local vaginal estrogen cream or tablets, systemic estrogen (and progesterone if needed) therapy, or selective estrogen receptor modulators (SERMs) (4). Speak with your healthcare provider to find the best option for you.

  • For dryness caused by a medication, talk to your healthcare provider about trying another medication or ways to treat the dryness while on the medication. 

  • If what your sexual partner does during sex doesn’t work for you, try discussing your sexual likes and dislikes with them. You may find that talking about it increases your arousal. If you lack the desire to have sex with your partner, you may want to re-evaluate your relationship or talk to a healthcare provider about any health issues affecting your libido.

  • Spending more time on foreplay can be a way to increase your natural lubrication. Another option is to use lube during sexual activity or masturbation.

Sexual health is complex. An answer for one person may not be the answer for another. Reach out to a healthcare provider to discuss how your physical, mental, and emotional health could impact your vaginal dryness and sexual satisfaction (11). Other professionals that may help could be a sex therapist or a pelvic floor physical therapist (10).

Personal lubricants can make sex better

More than 9 out of 10 women agreed or strongly agreed that lube made sex feel “more comfortable,” “more pleasurable,” and simply “better” (17).

In a 2013 study, lubricant use was associated with higher ratings of sexual pleasure and satisfaction in both solo masturbation and partnered sexual activities (17). Lubricants made with water or silicone can be used with latex condoms and diaphragms (18). 

Oil-based products, such as petroleum jelly, baby oil, mineral oil, or vegetable oils, are not recommended and are likely to damage latex condoms and/or diaphragms. This increases your risk of pregnancy or STIs. Petroleum jelly also increases your risk of  bacterial vaginosis (19). Hand or body lotions are not recommended either, as they can irritate vaginal tissues. 

Understanding the causes of vaginal dryness and taking steps to treat it can lead to a more fulfilling sex life, whether with another person or on your own. Reach out to a healthcare provider if none of the treatments above work for you. 

Download Clue to track your vaginal discharge, medications, and sex drive.

Article was originally published on Oct. 13, 2017.

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