Vaginal dryness is one of the most common symptoms of menopause, affecting up to 50% of postmenopausal women. Yet many suffer in silence because they're embarrassed to discuss it. Here's what you need to know about this treatable condition.
Understanding Genitourinary Syndrome of Menopause (GSM)
Vaginal dryness is part of a broader condition called GSM, which includes:
- Vaginal dryness and itching
- Burning or irritation
- Pain during sex (dyspareunia)
- Urinary symptoms (urgency, frequent infections)
- Vaginal thinning and loss of elasticity
Unlike hot flashes, which often improve over time, GSM typically worsens without treatment.
Why It Happens
Estrogen keeps vaginal tissue thick, elastic, and lubricated. When estrogen declines during menopause, the vaginal walls become thinner and drier, and the pH changes, making infections more common.
Treatment Options
Vaginal moisturizers: Over-the-counter moisturizers (like Replens) can help maintain vaginal moisture. Use regularly, not just during sex.
Lubricants: Water-based or silicone lubricants can make sex more comfortable. Avoid products with irritating ingredients.
Local estrogen: Vaginal estrogen (creams, tablets, or rings) is highly effective and delivers estrogen directly where it's needed with minimal systemic absorption. This is safe for most women, even those who can't take systemic HRT.
DHEA vaginal inserts: Prasterone (Intrarosa) is a vaginal DHEA insert that converts to estrogen and testosterone locally.
Ospemifene: An oral medication that acts like estrogen in vaginal tissue without being a hormone.
Laser treatments: Some clinics offer vaginal laser therapy, though evidence is still mixed.
Don't Wait to Treat
Early treatment can prevent worsening of symptoms. If you're experiencing vaginal dryness, talk to your healthcare provider about your options.
