Vaginal dryness is one of the most common intimate health concerns women have, and one of the least discussed. It can make everyday activities like sitting, exercising or wearing jeans uncomfortable, and it often makes sex painful. The good news is that it is very treatable. This guide covers what causes it, the symptoms to watch for, and when to see a clinician.
What is vaginal dryness?
Healthy vaginal tissue stays moist, thick and elastic, helped largely by the hormone estrogen. Estrogen supports blood flow, natural lubrication and the layers of cells that line the vagina. When estrogen drops, or when something else interferes with the tissue, the lining can become thinner, drier and more easily irritated. Clinicians sometimes call this vaginal atrophy. When it happens with menopause, it is part of what’s now called Genitourinary Syndrome of Menopause (GSM).
By the numbers
- The Menopause Society’s 2020 position statement estimates that genitourinary symptoms such as dryness affect 27% to 84% of postmenopausal women.
- In the REVIVE survey (Kingsberg et al., Journal of Sexual Medicine, 2013, 3,046 U.S. postmenopausal women), dryness was the most common symptom (55%), followed by pain during sex (44%) and irritation (37%).
- Only 24% of women in that survey linked their symptoms to menopause.
Common symptoms
- A dry, tight or “raw” feeling in or around the vagina
- Itching, burning or stinging
- Pain or discomfort during sex (dyspareunia), or light bleeding afterward
- Less natural lubrication during arousal
- Soreness when sitting, walking or exercising
- Urinary urgency, burning with urination or more frequent urinary tract infections
- Changes in discharge
What causes vaginal dryness?
Perimenopause and menopause
Falling estrogen is the most common cause (see perimenopause and after menopause). Symptoms can start in the years before your last period and tend to get worse over time if they are not treated. Unlike hot flashes, vaginal dryness usually does not go away on its own.
Postpartum and breastfeeding
Estrogen levels drop after childbirth and stay low while you are breastfeeding. Many new mothers notice dryness and discomfort, especially when they resume intimacy.
Cancer treatment
Chemotherapy, pelvic radiation, surgical removal of the ovaries and anti-estrogen medicines such as tamoxifen and aromatase inhibitors can all cause significant dryness. Women with a history of hormone-sensitive cancer often look for hormone-free options.
Medications
Antihistamines, some antidepressants, some hormonal birth control and other medicines can reduce natural moisture. See medications that cause vaginal dryness.
Other factors
- Autoimmune conditions such as Sjögren’s syndrome
- Smoking, which reduces blood flow to tissues
- Douching, scented soaps, bubble baths and harsh laundry products
- Stress, fatigue and not enough arousal before sex
- Removal of the ovaries or other causes of low estrogen at any age
Why am I dry down there all of a sudden?
Sudden vaginal dryness usually has a clear trigger. The most common are:
- A new medicine: antihistamines, decongestants, some antidepressants or hormonal birth control. See medications that cause vaginal dryness.
- Hormone shifts: perimenopause, the days before your period, after giving birth or while breastfeeding.
- A new soap, wash, wipe or detergent that irritates sensitive skin.
- Stress, tiredness or low arousal, which reduce natural lubrication. See can stress cause vaginal dryness?
- Cancer treatment or surgery that affects the ovaries.
If dryness comes with burning, unusual discharge, sores or bleeding, see a clinician, since an infection or skin condition can feel similar.
When to see a clinician
Talk to a doctor, nurse practitioner or gynecologist if dryness doesn’t improve with at-home care, if sex is consistently painful, or if you notice bleeding after menopause, unusual discharge, sores or recurring urinary infections. These can have other causes that need to be checked.
Looking for relief?
Learn about your options, from everyday moisturizers to prescription therapy and hormone-free serums.
Quick answers
Is vaginal dryness normal?
It is very common, especially during and after menopause, but that doesn’t mean you have to put up with it. Effective, safe options are available.
Can younger women have vaginal dryness?
Yes. Breastfeeding, some birth control, medicines, stress and medical treatments can all cause dryness before menopause.
Will it go away on its own?
Dryness from temporary causes, like breastfeeding, often improves over time. Dryness from menopause usually continues or gets worse without regular care.
Related reading
- Find a doctor, specialist or support
- Vaginal moisturizers & dryness creams: how to choose
- Vaginal dryness after hysterectomy
- How to talk to your doctor (and partner)
- Vaginal dryness in perimenopause
- Vaginal dryness after menopause
- Postpartum vaginal dryness
- Vaginal dryness after breast cancer
- Natural remedies: what works
- Painful sex after menopause
- Alternatives to vaginal estrogen
- Hyaluronic acid for vaginal dryness
- Vaginal moisturizer vs. lubricant
- What is vaginal atrophy?
- Medications that cause vaginal dryness
- Vaginal dryness in your 20s and 30s
- Vaginal itching, burning and dryness: causes
- Diabetes and vaginal dryness
- Exercise and vaginal dryness
- Can vaginal dryness cause bleeding?
- Birth control and vaginal dryness
- Vulvar dryness: why your vulva feels dry and itchy
- Can stress cause vaginal dryness?
- Sjögren’s and vaginal dryness
Sources
- The North American Menopause Society. The 2020 genitourinary syndrome of menopause position statement. Menopause. 2020;27(9):976–992.
- Perelmuter S, et al. Genitourinary syndrome of lactation (GSL): a new perspective on postpartum and lactation-related genitourinary symptoms. J Sex Med. 2024;21(Suppl 5).
- American College of Obstetricians and Gynecologists. Treatment of urogenital symptoms in individuals with a history of estrogen-dependent breast cancer (Clinical Consensus No. 2). Obstet Gynecol. 2021;138:950–960.