LOVE WELL • INTIMATE HEALTH

Vaginal dryness:
common, treatable, worth raising.

LAST REVIEWED: 2026-10-24 • By the LatelyWell editorial team • How we write & review

Vaginal dryness, soreness and discomfort during sex affect many women during and after menopause, yet many never mention it to a doctor. Unlike hot flashes, these symptoms often get worse over time without treatment. The good news is that safe, effective options exist.

What it can feel like

Vaginal dryness is often thought of only in terms of sex, but it can affect daily comfort too. Common symptoms include:

• Dryness, itching, burning or soreness in and around the vagina.
• Pain or discomfort during sex, and sometimes light bleeding afterwards.
• Discomfort when sitting, exercising or wearing tight clothes.
• Needing to pass urine more often or more urgently.
• Recurrent urinary tract infections (UTIs).

Because these changes affect the vagina, vulva, bladder and urethra together, doctors now often use the term genitourinary syndrome of menopause (GSM). You may also hear "vaginal atrophy" or "atrophic vaginitis". The NHS lists vaginal dryness and pain or discomfort during sex among the common symptoms of perimenopause and menopause.

Why it happens

Oestrogen helps keep the tissues of the vagina and vulva thick, elastic and moist, supports healthy blood flow, and helps maintain a healthy balance of vaginal bacteria. As oestrogen levels fall, these tissues can become thinner, drier and more fragile, and the vagina's natural acidity can change. That can make the area more easily irritated and more prone to infection.

Unlike hot flashes, which often ease with time, GSM symptoms tend to persist or worsen after menopause if they are not treated. They can also happen at other times when oestrogen is low, for example while breastfeeding, with some contraceptives, or after some cancer treatments.

You do not have to put up with it

Many women do not mention these symptoms, because of embarrassment, because they assume nothing can be done, or because they think it is "just ageing". Doctors and nurses are used to talking about it. You can bring it up directly, for example: "I've been having vaginal dryness and discomfort during sex, and I'd like to talk about treatment." If you have been given leaflets or treatment for hot flashes, it is still worth mentioning, because GSM is treated differently.

Self-care and over-the-counter options

Vaginal moisturisers

Vaginal moisturisers are used regularly, typically every two to three days, regardless of sex. They help the tissues hold moisture and can ease everyday dryness and itching. Several products are available without prescription in pharmacies and supermarkets, and some are available on NHS prescription.

Lubricants

Lubricants are used during sex to reduce friction and discomfort. Water-based and silicone-based lubricants are both options. Oil-based products can damage latex condoms. Some people find products with fragrances, warming agents or a high concentration of certain ingredients irritating, and some guidance suggests choosing products whose osmolality and pH are close to that of the vagina. A pharmacist can help you choose.

Avoid irritants

• Avoid perfumed soaps, bubble baths, douches, vaginal washes and wipes. Water or an unperfumed emollient is enough for the vulva.
• Wear breathable cotton underwear.
• Be aware that spermicides and some condoms can irritate.

Sexual activity and pelvic floor

Regular sexual activity or arousal can help maintain blood flow to the area, if that is comfortable and wanted. Pelvic floor exercises support bladder control, and a pelvic health physiotherapist can help with pain, tightness or leaks.

Prescription treatments

Vaginal oestrogen

Low-dose vaginal oestrogen, used as a cream, pessary (tablet), gel or ring, is a very effective treatment for GSM. It treats the tissues directly, and only small amounts are absorbed into the bloodstream. NICE recommends offering vaginal oestrogen to women with urogenital atrophy, including those on systemic HRT, and says treatment can continue for as long as needed. It notes that symptoms often come back when treatment stops.

Vaginal oestrogen does not carry the same risks as HRT taken as tablets or patches, and in the UK, some low-dose vaginal oestrogen tablets are now available from pharmacies without a prescription for women over 50 who have not had a period for at least a year. If you have had breast cancer, talk to your cancer team before using it; it may still be an option for some people.

The Menopause Society's 2020 position statement on GSM also describes low-dose vaginal oestrogen as an effective treatment, with minimal systemic absorption.

Other options

Depending on where you live, other prescription options include:

• Prasterone (DHEA) pessaries, which are converted into hormones within the vaginal tissue.
• Ospemifene, a tablet that acts on vaginal tissue like oestrogen.
• Systemic HRT can help vaginal symptoms, though some women need vaginal oestrogen as well.

Treatments such as vaginal laser therapy are marketed for GSM, but NICE and other bodies have said the evidence on their long-term safety and effectiveness is not yet sufficient for routine use. In 2018 the US FDA also issued a public warning about energy-based devices being marketed for "vaginal rejuvenation".

Bladder symptoms and UTIs

GSM can make you need to pass urine more often or urgently and can make UTIs more likely. Vaginal oestrogen can help reduce recurrent UTIs in postmenopausal women, and NICE guidance on recurrent UTIs includes it as an option to consider. Always see a doctor if you have signs of a UTI such as burning when you urinate, needing to go much more often, cloudy or bloody urine, or pain in your lower tummy or back, especially with fever.

Sex, relationships and desire

Pain during sex can understandably affect desire and relationships, and it can create a cycle where anticipating pain leads to tension, which makes sex more painful. Treating dryness often helps. So can taking more time for arousal, trying different positions, communicating with your partner, and remembering that intimacy does not have to mean penetration. If low desire is affecting you, it is worth mentioning separately; it has many possible causes and there is support available.

When to see a doctor

See a GP, nurse or doctor if:

• Dryness or discomfort is affecting your daily life or relationships.
• Over-the-counter products are not helping after a few weeks.
• You have any bleeding after menopause, or bleeding after sex. This should always be checked.
• You have unusual discharge, sores, lumps, or persistent itching.
• You have symptoms of a UTI, or keep getting UTIs.

Vulval itching can also be caused by skin conditions such as lichen sclerosus, which needs specific treatment, so persistent symptoms are worth examining.

Frequently asked questions

Is vaginal oestrogen the same as HRT?

Both contain oestrogen, but low-dose vaginal oestrogen works locally, and only small amounts are absorbed into the bloodstream. NICE says it can be used alongside systemic HRT and for as long as needed.

How long does vaginal oestrogen take to work?

Many people notice improvement within a few weeks, but it can take up to three months to feel the full benefit. Symptoms often return if treatment is stopped.

Can I use a moisturiser and a lubricant together?

Yes. Moisturisers are used regularly for everyday comfort, while lubricants are used during sex. Many women use both, sometimes alongside vaginal oestrogen.

Where to find reliable information

If you want to read further, these organisations publish free, evidence-based information for the public:

• UK: the NHS menopause pages, the NICE menopause guideline and the Women's Health Concern factsheets from the British Menopause Society.
• US: The Menopause Society, ACOG and the National Institute on Aging.
• Australia: Jean Hailes for Women's Health and the Australasian Menopause Society.

Guidance differs a little between countries, and treatment names and availability vary, so check what applies where you live and talk to a clinician about your own situation.

The bottom line

Vaginal dryness and related symptoms are very common after menopause and, unlike many other symptoms, tend not to go away on their own. Moisturisers and lubricants help many women, and low-dose vaginal oestrogen is a safe, effective treatment for most. You deserve to be comfortable, and it is worth raising with a healthcare professional.

Educational information only; not medical advice, diagnosis or treatment. Seek professional care for symptoms that are severe, persistent, worsening or concerning.