• Posted February 21, 2024

Treating Vaginal Dryness Around and After Menopause

Postmenopausal or peri-menopausal women are often hampered by vaginal dryness, which can put the brakes on a healthy sex life.

It doesn't have to stay that way, experts advised. Numerous products are available to help maintain vaginal lubrication.

"After and around the time of menopause, your body makes less estrogen," Dr. Cynthia Abraham explained in a column from the American College of Obstetricians and Gynecologists.

"Estrogen is a hormone that helps maintain the vagina's lubrication, elasticity and thickness," said Abraham, an ob/gyn at Mount Sinai in New York City. "Low levels of estrogen can cause thinning, drying and inflammation of vaginal walls. This is called vaginal atrophy."

Dryness can also affect the external tissues of the vulva, Abraham noted.

"Women with vulvar dryness often notice irritation when they're putting on their underwear," she said.

According to Abraham, it's also common for women to develop the condition in the years that precede menopause.

"Often, my patients notice symptoms when they haven't been sexually active for a long time," Abraham said. "Then they are intimate with a partner and find that sex is painful." 

What to do

Luckily, there are numerous products to choose from to help lubricate the vagina. According to Abraham and the Mayo Clinic's Dr. Shannon Laughlin-Tommaso, these include:

• Vaginal mosturizers. These include (among others) brands such as K-Y Liquibeads and Replens, Laughlin-Tommaso said in a column posted online by the clinic.

• Vaginal lubricants. Common brands include Astroglide, Jo, Sliquid and others. They're applied at the time of intercourse to ease pain and irritation.

  "Sexually active women should use lubricants in addition to a vaginal moisturizer," Abraham advised. "I prefer water-based lubricants, though they don't last as long as silicone-based products. Skip oil-based lubricants. They can cause irritation and make condoms less effective."

  If you're still experiencing pain during intercourse after using moisturizers/lubricants for two months, reach out to your doctor.

• Low-dose estrogen creams. These medications can also be dispensed via a vaginal ring or tablet, Laughlin-Tommaso explained. They can be used even if you're already on hormone replacement therapy, she added, although women who've had breast cancer may want to talk over using such products with their doctor.

  "Creams must be measured and can get messy," Abraham noted, so "tablets are a good alternative."

• Ospemifene (Osphena). This is a pill containing what's known as a selective estrogen receptor modulator (SERM) medication. It's used "to treat painful intercourse associated with vaginal atrophy," Laughlin-Tommaso said.

• Dehydroepiandrosterone (DHEA). Taken as a nightly vaginal suppository, DHEA "may ease painful intercourse in menopausal women," the Mayo expert said.

Laughlin-Tommaso also noted that simply engaging in regular sex or masturbation can help maintain healthy vaginal tissue post-menopause.

As always, "talk with your ob-gyn about the pros and cons of different hormonal options," Abraham said.

SOURCES: Cynthia Abraham, MD, obstetrician-gynecologist, Mount Sinai, New York City, and spokesperson, American College of Obstetricians and Gynecologists; Shannon Laughlin-Tommaso, MD, obstetrician-gynecologist, Mayo Clinic

What This Means for You

Vaginal dryness is a common and debilitating condition before, during and after menopause, but numerous products can help