Quick answer: Vaginal dryness is very common during perimenopause and after menopause, because lower oestrogen makes the vaginal tissue thinner and less elastic. It can make sex uncomfortable and cause itching or soreness. A good lubricant helps during sex, a vaginal moisturiser used regularly helps day to day, and your GP can talk to you about treatments such as low-dose vaginal oestrogen.
Key takeaways
- Lower oestrogen around menopause is the most common cause of dryness.
- Lubricants are for sex; vaginal moisturisers are used regularly for everyday comfort.
- Choose gentle products without fragrance, flavour, warming ingredients or glycerin.
- Silicone lube lasts longer and suits dryness well.
- Your GP can discuss effective treatments, so you do not have to just live with it.
Why menopause causes dryness
Oestrogen helps keep the vaginal walls thick, stretchy and moist. As levels fall during perimenopause and menopause, the tissue can become thinner, drier and more easily irritated. Doctors sometimes call this the genitourinary syndrome of menopause, because it can also cause urinary symptoms. Dryness can also happen while breastfeeding, during some cancer treatments and with certain medicines.
Signs to look out for
- Discomfort, burning or pain during sex
- Itching or soreness, even when you are not having sex
- Light bleeding after sex
- Needing to wee more often, or more urinary infections
Any bleeding after menopause should always be checked by your GP, even if you think dryness is the reason.
Lubricant or vaginal moisturiser?
They do different jobs, and many women use both:
- Lubricant is used during sex or play to reduce friction. Water-based lube is easy to clean up and condom-safe; silicone lube lasts much longer and is great for dryness. Our lube guide explains the differences.
- Vaginal moisturiser is used every few days, regardless of sex, to keep tissue more comfortable. You will find these at pharmacies.
Choosing gentle products
Sensitive tissue can react to some ingredients. Look for products without added fragrance, flavour, warming or tingling effects, and consider glycerin-free and paraben-free formulas. Patch-test anything new, and stop using it if it stings.
Other things that can help
- Take your time. Longer foreplay gives your body more chance to become aroused and naturally lubricated.
- Regular sexual activity, including solo play, increases blood flow to the area, which many women find helps.
- Avoid irritants: skip perfumed soaps, douches and bubble baths, and wash the vulva with water or a gentle wash.
- Talk to your GP. Low-dose vaginal oestrogen is a common, effective treatment for menopausal dryness, and menopausal hormone therapy may also be an option. Your GP can explain whether these suit you.
Frequently asked questions
What is the best lube for menopause dryness?
Many women find silicone lube works best because it lasts longer. A gentle water-based lube without glycerin, parabens or fragrance is also a good choice, especially with condoms.
What is the difference between a lubricant and a vaginal moisturiser?
A lubricant is used during sex to reduce friction. A vaginal moisturiser is used regularly, every few days, to keep the tissue more comfortable day to day.
Can vaginal dryness be treated?
Yes. As well as lubricants and moisturisers, a GP can prescribe treatments such as low-dose vaginal oestrogen, which helps many women.
Is it normal to bleed after sex after menopause?
Light bleeding can happen with dryness, but any bleeding after menopause should be checked by a GP to rule out other causes.
Does dryness only happen at menopause?
No. It can also happen while breastfeeding, with some contraceptives and medicines, during cancer treatment, or simply when you are not aroused enough.
This article is general information, not medical advice. Everyone is different, so please talk to your GP or a sexual health clinic about your own situation. Helpful Australian resources: Healthdirect: vaginal dryness, Healthdirect: menopause, Jean Hailes: menopause symptoms.
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