Vaginal dryness is one of the most common, and least talked about, changes around menopause. As estrogen falls, the vaginal tissues become thinner, drier and less elastic. It can start in perimenopause, it tends not to go away on its own, and it responds well to treatment.
In short
- Falling estrogen makes the vaginal and vulval tissues thinner and drier. Doctors call this vulvovaginal atrophy or genitourinary syndrome of menopause (GSM).
- Symptoms include dryness, itching, burning, pain during sex and needing to pee more often.
- Lubricants and moisturisers help many women, and a doctor can prescribe local estrogen if needed.
What does vaginal dryness feel like?
It can feel like soreness, itching or burning in and around the vagina, or discomfort when sitting, exercising or wearing tight clothes. Sex may be uncomfortable or painful. Ireland's HSE notes that dryness can also come with needing to pee more often and repeated urinary infections.
Why does it happen in perimenopause?
Estrogen keeps the vaginal lining thick, moist and elastic. When levels fall, the tissues thin and produce less moisture. The European Menopause and Andropause Society (EMAS) describes this as a long-term, progressive change caused by low estrogen, affecting around half of women after menopause.
Other things can cause or worsen dryness too: breastfeeding, some contraceptive pills, antidepressants, cancer treatments, diabetes, and scented soaps or washes.
Does it go away on its own?
Usually not. Unlike hot flushes, which often ease with time, vaginal dryness tends to continue or slowly get worse after menopause. EMAS notes that symptoms often come back when treatment stops, which is why many women use treatment long-term.
What helps with vaginal dryness?
- Lubricants ease friction during sex. Water- or silicone-based ones are widely available at pharmacies.
- Vaginal moisturisers are used regularly, a few times a week, not just before sex.
- Avoid irritants. Skip perfumed soaps, washes and douches around the vagina, and use only products made for vaginal use.
- Ask your doctor about local estrogen. Low-dose estrogen as a cream, tablet, ring or pessary works directly on the tissues. EMAS notes that low-dose vaginal estrogen does not meaningfully change hormone levels in the rest of the body. Whether it suits you is a question for your doctor.
- Pelvic floor exercises can also help some women, especially with bladder symptoms.
A pharmacist can advise you privately on which products to try.
When to see a doctor
See your doctor if dryness hasn't improved after a few weeks of self-care, if it affects your daily life or relationship, or if you keep getting urinary infections.
See a doctor promptly if you have bleeding after sex, bleeding between periods, unusual discharge, or any bleeding after 12 months without a period.
A short diary of your symptoms and cycle, on paper or in an app like Pausie, helps your doctor see what has changed and since when.
Frequently asked questions
Can perimenopause cause vaginal dryness even with periods?
Yes. It's more common after menopause, but it can start while you still have periods.
Is vaginal dryness the same as itchy skin?
Not quite. Both can be linked to lower estrogen, but vaginal symptoms need their own treatment. See also Itchy skin in perimenopause.
Can vaginal dryness lower my sex drive?
It can. When sex is uncomfortable, desire often drops too. More in Low sex drive in perimenopause.
Does HRT help vaginal dryness?
Hormone therapy can help, but local vaginal estrogen is often used for dryness on its own or alongside it. Your doctor can explain the options.
Notice what changes
Log »Vaginal dryness« and your cycle in Pausie and see how it changes over months. Your doctor gets a clear picture without you having to remember. No account, and your diary stays on your phone.
This article is general information, not medical advice. Written by the Pausie team. Published and last reviewed 2 November 2026.
Sources
- EMAS Menopause Essentials: Vulvovaginal atrophy
- EMAS Menopause Essentials: Menopausal symptoms
- HSE Ireland: Vaginal dryness
- InformedHealth.org (IQWiG): Menopause