What is vaginal dryness?

Vaginal dryness is when your vagina has less moisture than usual.

Vaginal dryness is most common in females who have gone through menopause. It affects most females after menopause but many people don't report it to their healthcare provider or get treatment.

What are the symptoms of vaginal dryness?

You may have vaginal dryness if you:

• have vaginal itchiness or irritation
• feel pain or discomfort during sex
• need to urinate (wee) more often than usual

You may also have recurring urinary tract infections (UTIs).

Vaginal dryness can reduce sexual desire when sex becomes uncomfortable rather than pleasurable.

What causes vaginal dryness?

The most common cause of vaginal dryness is lower levels of oestrogen. Oestrogen is the female hormone that maintains the vaginal lining and tissue elasticity (stretchiness).

A drop in oestrogen levels can happen due to:

• menopause
• surgery to remove the ovaries
• cancer treatment
• weaning after breastfeeding — your oestrogen levels will go back to normal as you breastfeed less often
• some medicines, such as some antidepressants

Vaginal dryness can also happen when your vagina does not make enough natural moisture.

This may be caused by:

• reduced blood flow to the vaginal tissues
• the lining of the vagina becoming thinner
• changes to the normal vaginal bacteria balance
• irritation and inflammation

Other causes linked to vaginal dryness include:

• vaginal douching (washing out the vagina)

• smoking
• an underlying condition, such as diabetes
• stress and anxiety
• not enough foreplay or arousal before sex

When should I see my doctor?

Many people do not report their symptoms to their doctors. It is important to know that there are treatments that can ease your discomfort.

See your doctor if you have had vaginal dryness for a few weeks and the things you have tried yourself are not working.

You should also see your doctor if:

• vaginal dryness is affecting your daily life
• you have unusual discharge or bleeding from your vagina
• you have bleeding after sex or between your periods

How is vaginal dryness diagnosed?

Vaginal dryness can be diagnosed by your doctor. They will talk with you about your symptoms and may also examine you. You have the right to ask for a support person to be with you during a medical examination.

Depending on your situation, your doctor may refer you to a gynaecologist — a doctor who specialises in female health.

How is vaginal dryness treated?

Vaginal dryness can be treated with lubricants and vaginal moisturisers or hormone medicines.

Lubricants and vaginal moisturisers

Lubricants and vaginal moisturisers can ease your symptoms. You do not need a prescription for these treatments. You can buy these products at your local pharmacy or supermarket.

You may want to consider using a vaginal moisturiser 2 to 3 times a week and using water-based lubricants when having sex.

Menopausal hormone therapy

If you have vaginal dryness because of changes in your hormone levels around the time of menopause, your doctor may suggest menopausal hormone therapy (MHT), also known as hormone replacement therapy (HRT).

MHT can be given as:

• creams
• gels
• patches
• transvaginal ring (a small round device with hormones you can wear inside your vagina)

Speak with your doctor about which option is best for you.

What are the complications of vaginal dryness?

If vaginal dryness is not managed, it can cause ongoing discomfort and may affect your quality of life. Complications include:

• worsening pain with sex
• small tears or trauma to the vaginal tissue during sex
• recurrent infections
• reduced sexual desire or sexual activity

Can vaginal dryness be prevented?

There are some things you can do to help you prevent vaginal dryness.

You should avoid:

• excessive vaginal douching
• smoking cigarettes
• perfumed soaps, washes, bubble baths or essential oils that may be irritating
• tight-fitting clothes — choose cotton underwear
• dehydration — drink plenty of water

Resources and support

If you would like more information or support, the following organisations and services can help:

• Jean Hailes for Women's Health has more information about the vulva and vagina, vulvovaginal atrophy, as well as resources for Aboriginal and/or Torres Strait Islander peoples. They also have easy read fact sheets and videos to help people living with disability.
• The Royal Australian College of General Practitioners (RACGP) has recommendations for good vulval care.
• You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.

Languages other than English

• Family Planning Australia has information on common vaginal and vulval conditions in many languages.
• Jean Hailes for Women's Health has fact sheets on vulval and vaginal health in several community languages.