Vaginal dryness: Why it happens and what you can do about it

Top things to know:

• Vaginal dryness can have physical or psychological causes
• Vaginal lubrication is closely tied to levels of the hormone estrogen, which change throughout the menstrual cycle and at various life stages
• Medications (including hormonal birth control) can cause vaginal dryness
• You can have a happy and healthy sex life even if you don’t produce much natural vaginal lubrication

Vaginal dryness is a common but treatable problem that can happen at any age. Symptoms may include pain during sex or masturbation, burning vaginal discomfort or itching, or abnormal vaginal discharge. There can be a number of reasons for vaginal dryness, both psychological and physiological, and some of them might surprise you. Whether you’re drier than you would like to be during sexual activity, or you’re experiencing more general discomfort due to vaginal dryness, here are some of the possible causes — and solutions:

How vaginal dryness is related to estrogen levels

The hormone estrogen helps to keep the vagina moist and to maintain thickness of the vaginal lining. Vaginal dryness, also known as atrophic vaginitis, is a common condition that can occur when the ovaries produce a decreased amount of estrogen.

Your body produces less estrogen:

• At the time of menopause.
• At the beginning and end of the menstrual cycle (estrogen is at its highest in the days leading up to and around ovulation).
• After having a baby, particularly if breastfeeding.
• After surgical removal of the ovaries, chemotherapy, or radiation therapy of the pelvis for cancer.
• While using certain medications, including some forms of hormonal birth control. When these medications are stopped, estrogen production resumes.
• If you’re a smoker. Cigarette smokers have been shown to have an increased risk of an earlier menopause transition as compared to non-smokers. This means that atrophic vaginitis symptoms may appear at a younger age in this population.

Vaginal lubrication and sex

If you’re noticing dryness during vaginal sex, this could be for a number of reasons. Maybe what your partner is doing just doesn’t turn you on. If you feel turned on but are still dry, your body might simply need time to catch up with your brain. If you’re noticing vaginal dryness along with a lack of sexual desire, you may be experiencing low libido, which can be caused by a number of factors including medication and health conditions. Or you just might not be all that into your partner or the acts you are performing together.

Your sexual desire is influenced by some of the same hormones that fluctuate with your cycle, like estrogen and progesterone. You may find your desire tends to increase in the days leading up to ovulation and decrease shortly after ovulation is over (1, 2). Sex drive may be lower when more progesterone is produced during the luteal phase (the days after ovulation and leading up to menstruation) (2). Exactly how reproductive hormones influence desire and preference isn’t the same for everyone; some people report a higher sex drive around the time of menstruation (3). Tracking can help you discover what’s true for you.

What can you do about vaginal dryness?

If you’re experiencing dryness since being on the pill or another form of hormonal birth control, talk to your doctor about trying another one that’s a better fit for your body. If you suspect your dryness could be caused by low estrogen levels, there are several treatment options: vaginal moisturizers or lubricants, vaginal estrogen, a pill called ospemifene, and a vaginal tablet called prasterone, or dehydroepiandrosterone (DHEA). See your healthcare provider to find out what’s the best option for you.

If what your sexual partner is doing doesn’t work for you, you could try discussing your sexual likes and dislikes — you may even find that just talking about it increases your arousal. If you lack desire for your partner, it’s up to you what you do from there, whether you want to re-evaluate your relationship or investigate any health issues that might be messing with your libido.

If you feel turned on but you’re not wet, then spending more time on foreplay can be one way to increase your natural lubrication. Another option is to use personal lubricant (lube) during sexual activity or masturbation.

Lube: simply better sex

In a 2013 study, lubricant use was associated with higher ratings of sexual pleasure and satisfaction in both solo masturbation and partnered sexual activities. More than 9 out of 10 women in the study agreed or strongly agreed that lube made sex feel “more comfortable,” “more pleasurable,” and simply “better” (4).

Lubricants made with water or silicone can be used with latex condoms and diaphragms. Oil-based products, such as petroleum jelly, baby oil, mineral oil, or vegetable oils are not healthy to use internally, and are likely to damage latex condoms and/or diaphragms and make them less effective at preventing pregnancy or STIs.

A study published in the journal Obstetrics and Gynecology found that women who had used petroleum jelly as lube in the past month were more than twice as likely as non-users to have bacterial vaginosis (5). Hand or body lotions are not recommended either, as they can be irritating to vaginal tissues.

If you prefer to use something natural, avoid using food products like olive oil or coconut oil as this can lead to yeast infections or bacterial vaginosis. Instead, try an organic lubricant or a water-based lube without additives.

When using personal lubricants with a partner, check that they don’t contain Nonoxynol-9 (n-9), a spermicide that has been shown to cause skin irritations and tears that allow viruses (including HIV) to be transmitted more easily. Nonoxynol-9 can also increase the likelihood of acquiring a vaginal yeast infection or urinary tract infection.

Still dry? This could be why:

Aside from sexual arousal and estrogen levels, there are additional factors that can affect vaginal lubrication:

Dehydration due to heat, illness or alcohol consumption can leave your vagina dry, too. In this case, lubrication should return when you are sufficiently rehydrated.

Have you been taking medication for a cold or allergies? Antihistamines in cold and allergy medications dry out your body, including your vagina, but natural lubrication should return when you stop the medication.

Stress can cause the body to produce higher levels of the hormone epinephrine, which interferes with the body’s sexual response cycle and therefore impedes vaginal lubrication. If this applies to you, stress-reducing activities can help.

If you’ve checked out everything else and still don’t find the culprit, you might have an allergy to chemicals in soap, detergent, lubricant or hygiene products — these can also cause vaginal dryness or irritation. Try switching to natural products and wash with unperfumed soap or just water, and see if your symptoms improve. Your vagina is self-cleaning, so there is no need to use any internal washes (douches) or vaginal deodorants — in fact, they can be harmful. Research has linked the practice of douching with increased risk of bacterial and yeast infections, pelvic inflammatory disease, cervical cancer, increased transmission of STIs, and other adverse health outcomes (6, 7).

Use Clue to track fluid throughout your cycle.

References

1. Burleson MH, Trevathan WR, Gregory WL. Sexual behavior in lesbian and heterosexual women: Relations with menstrual cycle phase and partner availability. Psychoneuroendocrinology. 2002 May 31;27(4):489–503.
2. Roney JR, Simmons ZL. Hormonal predictors of sexual motivation in natural menstrual cycles. Hormones and Behavior. 2013 Apr 30;63(4):636–45.
3. Campagne, Daniel M. and Ghislaine Campagne. 2007. “The Premenstrual Syndrome Revisited.” European Journal of Obstetrics Gynecology and Reproductive Biology 130(1):4–17.
4. Jozkowski KN, Herbenick D, Schick V, Reece M, Sanders SA, Fortenberry JD. Women’s perceptions about lubricant use and vaginal wetness during sexual activities. The journal of sexual medicine. 2013 Feb 1;10(2):484–92.
5. Brown JM, Hess KL, Brown S, Murphy C, Waldman AL, Hezareh M. Intravaginal practices and risk of bacterial vaginosis and candidiasis infection among a cohort of women in the United States. Obstetrics & Gynecology. 2013 Apr 1;121(4):773–80.
6. Martino JL, Vermund SH. Vaginal douching: evidence for risks or benefits to women’s health. Epidemiologic reviews. 2002 Dec 1;24(2):109–24.
7. Ness RB, Soper DE, Holley RL, Peipert J, Randall H, Sweet RL, Sondheimer SJ, Hendrix SL, Hillier SL, Amortegui A, Trucco G. Douching and endometritis: results from the PID evaluation and clinical health (PEACH) study. Sexually transmitted diseases. 2001 Apr 1;28(4):240–5.