Vaginal Dryness and Sexual Wellness

What vaginal dryness is

Vaginal dryness is a common problem that many women have at some point. [1] Symptoms include soreness, itching, discomfort or pain during sex, needing to urinate more often, and repeated urinary tract infections. [1] In menopause, dryness can come with burning, irritation and painful sex. [2]

Common causes

The NHS lists menopause, pregnancy and breastfeeding, some medicines such as hormonal contraceptives or antidepressants, removal of the uterus (especially with the ovaries), and cancer treatments. Other causes include perfumed soaps, washes or douches, not being aroused during sex, and conditions such as diabetes or Sjogren's syndrome. [1] Many of these change hormone levels. [1] In clinical research, dryness, painful sex and urinary symptoms after menopause are grouped as "genitourinary syndrome of menopause" (GSM). [3][4]

What you can try yourself

The NHS suggests water-based lubricants before sex, vaginal moisturizers for ongoing dryness, unperfumed soaps, and different approaches to foreplay to feel more aroused. It advises avoiding perfumed soaps, washes and douches, and creams or lotions not made for the vagina, as these can cause irritation or infection. [1] Lubricants and moisturizers are available without a prescription, and a pharmacist can help you choose. [5] Do not use oil-based lubricants with condoms, as they can damage condoms. [5]

Treatments from a clinician

Hormonal treatments are not recommended for everyone, so a clinician should review your history. [1]

Sexual wellness beyond dryness

MedlinePlus lists several kinds of sexual problems: lack of desire, difficulty becoming aroused, lack of orgasm, and painful intercourse. Causes can be physical (such as diabetes, heart disease or hormone problems), related to medicines, or psychological (such as stress, anxiety or relationship concerns). [7] Occasional problems are common, and problems lasting more than a few months or causing distress are worth discussing with a clinician. [7]

For low sexual desire around menopause, the NHS says testosterone gel or cream may help some people and can be prescribed by a menopause specialist, and notes there are many other possible reasons. [8]

Supplements for libido or "sexual wellness": NCCIH says there is not enough reliable evidence to know whether chasteberry helps sexual dysfunction. [9] In the sources we read, we did not find reliable evidence for other herbs or supplements. Proper evidence not found. See black cohosh, soy, red clover and hormone claims and medication interactions.