Vaginal dryness

Dryness is a symptom, not a diagnosis. It is most common after menopause, but it happens at every age, and the right response depends entirely on the cause.

How lubrication normally works

The vaginal walls are constantly moist from fluid that passes through the tissue, supplemented by secretions from glands near the entrance during arousal. Both depend on healthy, well supplied tissue, and the second also depends on adequate arousal time and blood flow. That gives two distinct kinds of dryness: tissue that has changed, and tissue that is fine but has not been given time.

The distinction is practical. Dryness that is present all the time, including when not aroused, points to the tissue. Dryness that appears only during sex, with normal comfort otherwise, points more often to arousal, and to the fact that arousal takes longer than most people assume.

Causes

Low oestrogen

The commonest cause of persistent dryness. After menopause, oestrogen remains low permanently and the tissue thins, which is described in full on the genitourinary syndrome page. Oestrogen is also low while breastfeeding, after removal of the ovaries, during treatments that suppress oestrogen, and in premature ovarian insufficiency. Breastfeeding related dryness is temporary and resolves as periods return, but it does not need to be endured in the meantime.

Medications and treatments

Some hormonal contraceptives reduce lubrication in some users. Antihistamines and some antidepressants can reduce it. Chemotherapy and pelvic radiotherapy affect the tissue directly. If dryness began within a few months of starting a medication, that is worth raising rather than assuming coincidence.

Skin conditions

Lichen sclerosus and other vulval skin conditions cause dryness alongside itching, colour change and sometimes splitting of the skin. These need diagnosis and prescribed treatment, and no lubricant will resolve them.

Irritants

Soap, shower gel, bubble bath, wipes, douches, perfumed liners and heavily fragranced washing products all strip and irritate. Stopping them is free and helps a surprising number of people. See vulval hygiene.

Arousal and context

Anxiety, tiredness, distraction, pain anticipated from previous experience, and simply not enough time all reduce lubrication in tissue that is otherwise normal. This is not a lesser cause, and treating it as one is why many people go looking for a medical explanation that does not exist. See low libido.

Lubricants and moisturisers are not the same thing

A lubricant is used at the time of sex and works immediately by reducing friction. A vaginal moisturiser is used regularly, whether or not sex is happening, and works over days by holding water in the tissue. Many people with persistent dryness use both. Neither changes the underlying tissue in the way that oestrogen does.

Choosing a lubricant

Three properties matter for sensitive tissue.

• Base. Water based lubricants are easy to wash off, are compatible with condoms, and need reapplying during longer use. Silicone based lubricants last considerably longer and suit use in water, though they are harder to wash away afterwards. Oil based products, including plain oils, degrade latex condoms.
• Osmolality. A product that is much more concentrated than body fluids draws water out of the cells and can cause stinging and irritation with repeated use. This is the single most useful thing to know when tissue is already fragile, and it explains why some products sting even though they are marketed as gentle.
• pH and additives. Fragrance, flavouring, warming or tingling agents, and some preservatives are common causes of irritation. For sensitive or postmenopausal tissue, the plainest formulation available is usually the right one.

Independent retailers that separate their lubricants into categories, including natural lubricants, such as inWonderstate, make this comparison easier than shelves that group everything together. What matters is the ingredient list rather than the description on the front.

Apply more than seems necessary, apply it to both partners or to any device being used, and reapply rather than pushing through friction. Friction on thin tissue causes microscopic tears, which cause stinging afterwards, which builds anticipation of pain.

When a product is not the answer

Dryness with any of the following needs an examination: itching that persists, white or thickened patches, splitting of the skin, bleeding, a changed discharge, or pain that continues despite lubrication. Persistent dryness after menopause is usually best treated at the tissue level with vaginal oestrogen rather than managed indefinitely with products, and that is a conversation worth having rather than avoiding.

Last reviewed: September 2026