Vaginal dryness is very common.
While it is most associated with menopause, there are other reasons a person may experience vaginal dryness. Understanding vaginal anatomy, the reasons for your dryness, and treatment options can help change your approach to treatment and self-care.
What people refer to as the “vagina” is often more than just the actual vagina. The genital region for people with a vagina includes the vulva (including the inner and outer lips), the clitoris, the urethral opening, the vaginal opening, the vaginal canal, the vagina, and the cervix.
Each part serves different purposes. The inner and outer lips protect the sensitive structures underneath them and prevent things from traveling into the vaginal canal accidentally. The urethra is for urine elimination.
The vaginal opening and canal allow menstrual blood to flow out of the body and can be penetrated for reproduction or pleasure. The cervix protects the uterus, allows sperm to pass through to fertilize an egg, allows menstrual blood to pass out, helps hold the fetus and amniotic sac in place during pregnancy, and expands during childbirth.
The clitoris is purely there to produce pleasure.
The vagina produces lubrication all the time. The vaginal secretions come from the cervix and the Bartholin glands – two pea-sized glands at the entrance of the vagina.
These secretions protect the vagina from tearing and illness. When aroused, you will secrete additional lubricant (often called “getting wet”) to protect your body from the extra friction.
Vaginal dryness refers to times when your body decreases the amount of vaginal secretions or ceases to produce any secretions at all.
Symptoms of Vaginal Dryness
Vaginal dryness is not always obvious at first. Symptoms which may indicate vaginal dryness include feeling itching or pain around the vaginal area; increased need to urinate; increased urinary tract infections, and pain during sex. Because these symptoms are not unique to vaginal dryness, it may be difficult to pinpoint wat is going on.
Itching, pain, and an increased need to urinate can also be signs of several sexually transmitted diseases (STIs). If you are outside the range of peri- or menopause or if you have knowingly engaged in sex without protective barriers (e.g., internal condoms, external condoms), you will want to be tested for STIs.
Pain during sex is also not unique to vaginal dryness. Endometriosis, vaginismus, prior injury or infection, and other things may cause an onset of pain with penetration. Having a routine gynecological exam and PAP smear can help clarify the reasons for some of these symptoms.
Because medical science in the west has been dominated by men, most of the understanding of people with vaginas is limited to the reproduction cycle. This means we know a bit about what happens to bodies when we stop being able to become pregnant, but the rest of this remains less known. When doctors bring up vaginal dryness, it is almost exclusively in relationship to menopause or perimenopause.
Menopause is the period in a person’s life where they cease having a period. Perimenopause occurs in the years right before you stop having a period. Your hormones are fluctuating, and you have increasingly irregular periods. Menopause is “diagnosed” when you have been without a period for twelve months. Post-menopause is the rest of your life after menopause.
Most people enter menopause between their mid-40s and mid-50s, however there is a large amount of personal variation to the start date. As your body stops producing the levels of estrogen and progesterone necessary for regular periods, you may experience vaginal dryness.
Non-menopause Causes of Vaginal Dryness
If menopause is not the reason for vaginal dryness, it can be useful to figure out what is at the root of the problem. Common causes include hormone changes, autoimmune conditions, medications, and psychological conditions.
Estrogen is a primary driver in helping the vagina secrete lubrication. If your estrogen levels fall, you can experience vaginal dryness. Common reasons estrogen falls for people include, giving birth, breastfeeding, cancer, chemotherapy, and hormone-suppressing treatments.
Less common reasons for low-estrogen may include:
- Excessive exercising
- Low-functioning pituitary gland
- Autoimmune diseases (e.g., Systematic Lupus, Sjogren’s Disease, Hashimoto’s Disease)
- Chronic kidney disease
- Turner’s syndrome
Many doctors who specialize in eating disorders, autoimmune disorders, and kidney disease receive very little training about sexuality. On average, an American medical student will get approximately four hours of training on “female sexuality.” If you are experiencing vaginal dryness and have one of the above conditions, the probability you know more about female sexuality as it pertains to your disease than your specialist is pretty high.
If you are experiencing symptoms of vaginal dryness and live with one of the conditions above, ask your specialist, your gynecologist, or your primary care physician to order a blood test for estrogen levels. This is a simple way to see if low estrogen may be at the root of your vaginal dryness.
Autoimmune Diseases and the Skin
Autoimmune diseases are diseases where your body’s immune system does not recognize your own body. Your immune system will then attack a body part as if it were an “invader” and cause serious issues.
Sjogren’s Syndrome may be a primary condition or develop as part of another autoimmune condition such as Lupus. Sjogren’s syndrome causes your mucus membranes to dry out. This includes your mouth, your eyes, your nose, and your vagina. Sjogren’s can be treated with autoimmune suppressing drugs in extreme cases. Most of the time, people with Sjogren’s simply treat the symptoms with eye drops, mouthwash, saline nose sprays, and vaginal lubricants.
Schleroderma is an autoimmune condition which affects the skin and sometimes internal organs. People with schleroderma over-produce collagen. As a result, the skin on their hands, torsos, and other body parts tend to thicken. It can also attach the glands which secrete vaginal lubrication and cause vaginal dryness. Depending on the type of schleroderma you have and its extent, you may be treated with autoimmune suppressing drugs or just treat the symptoms of the disease.
There are more than 300 drugs which cause vaginal dryness. Because this is a symptom which impacts mostly women and it involves sexuality, very few doctors will tell you about vaginal dryness as a side effect of a medication.
The most common drugs which cause vaginal dryness are antihistamines (e.g., Benadryl, Zyrtec) and cold medications (e.g., Nyquil, Sudafed). Antidepressants and anti-anxiety medications can also cause vaginal dryness. These include common medications such as Wellbutrin, Lexapro, and Cymbalta.
For a full list of medications associated with vaginal dryness, please check out this link.
Douching and Steaming Your Vagina
American corporations have made millions convincing people that their vaginas are dirty and need to be cleaned. This is completely false. The vagina self-cleans by secreting lubrication. To clean your genitals you should use warm, soapy water on your inner and outer lips and pubic mound and rinse well. You do not need to douche or use soap and water internally or steam clean your vagina.
Douching and steaming your vagina can disrupt the pH levels and cause vaginal dryness and discomfort. If you have been douching or steaming your vagina, stop. You should have normal pH levels return within a few weeks and see an increase in personal lubrication.
Treating Vaginal Dryness
It is important to be informed about your treatment options when it comes to vaginal dryness. As mentioned above, most doctors other than gynecologists, lack sufficient training in sexual health to have an adequate conversation about your options.
If the cause of vaginal dryness is menopause or low estrogen, using a hormone replacement may be your best option. This can include pills, estrogen creams, or a vaginal ring with estrogen in it. Not everyone with low estrogen is a candidate for hormone replacement. People with specific genes making them more likely to develop hormone receptive cancers, people who have undergone specific chemotherapies, and people who are on hormone suppression for gender affirmation may not be able to take estrogen replacements.
Some treatments for vaginal dryness include vaginal suppositories. These may be prescription or over-the-counter medications. A small pill is inserted into your vagina to help stimulate or replace vaginal secretions. Vitamin E and other ingredients are included in the suppositories to help increase the amount of lubrication in the vagina.
If your vaginal dryness is short-term, the result of allergy medication, or some illnesses, using a personal lubricant can be a great option to reduce vaginal dryness. You will want to find the lubricant which best suits you.
When it comes to choosing a personal lubricant, you will want to consider the following:
- How it feels
- How long it lasts
- How it smells
- How it tastes
Luckily, we live in a period where there are thousands of options for personal lubricant. From all natural and organic to edible, to ones which make your bits tingle, you have options!
The most important thing in choosing a personal lubricant is to find one which feels good when you use it. Lubricants have different levels of slickness and viscosity to them. Finding one which most resembles your own secretions is a good guide to picking one you will like.
Sliquid makes a great line of personal lubricants. This brand has consistently produced high-quality, long-lasting personal lubricants for decades. Sliquid Organics is an all-natural, organic lubricant which closely resembles most autonomously produced secretions.
Intimate Earth also produces a great line of all-natural lubricants. Their Soothe version is a great thicker option. If you have a lot of sensitivity or pain with sex, this thicker, soothing option may be the right choice!
If you don’t know where to start, consider ordering sample packs of lube from specific vendors. Many lube companies will offer a trial package of their different lubricants to help you find one which works for you.
Dealing with Stigma
There is a myth that vaginal dryness means you are not turned on enough for sex. While in some cases, that may be true, chronic vaginal dryness is an underlying health condition or side effect of a medication. You can be very turned on and still not produce enough lubrication for comfortable sex.
If you have been avoiding using lubrication because you are afraid your partner might be upset or insulted by that, it is important to talk to them. Sexual intercourse should be comfortable. It is not normal to experience unwanted pain with vaginal intercourse. Using lubrication is just part of healthy, happy sexual relationships.
In fact, even when you produce enough personal lubrication to have sex comfortably, adding extra lube makes sex even better! I am a huge advocate for adding lubrication to sex all the time. It feels better for you. It feels better for your partner. It is an easy way to double your pleasure and double your fun.
If you have a hard time starting a conversation with your partner about using lubricant as part of your sexual encounter, try some of the following suggestions:
- Explain the underlying reason of lack of lubricant
- Assure them that you enjoy sex and want to keep having great sex with them
- Suggest adding a warming, cooling, of flavored lubricant for “fun”
- Frame it around increasing their pleasure
The one drawback to using personal lubricant for sex is having to look for the bottle and fumble with it during a moment of passion.
Unless you are already buying the large pump bottles of lube, opening the small cap and handling it (especially for a second or third application) can result in slipping, spilling and general frustration.
I strongly suggest getting a soap dispenser and filling it with lubricant to keep by the bedside. You can find a dispenser which matches your décor. Being able to reach over for a quick pump makes it much easier to incorporate lube into your sex. You may even want to invest in a hand soap warmer.
These warmers keep the lube at 80 or 85 degrees Fahrenheit and it eliminates the cold shock of fresh lube.
If you want to make sure lube gets into the full length of your vaginal canal, purchase a lube shooter. A lube shooter looks like a rounded syringe which allows you to fill it with lubricant, and then insert it into your vagina and lubricate deep into the vaginal canal.
For people with more serious vaginal dryness, this can greatly increase your comfort during sex.
Keep a hand towel close by during sex. If you generally have sex in the bedroom, keeping a small hand towel in a side table drawer, tucked between the mattress and box frame, or just under the bed is very helpful as you incorporate lube into your sex life.
When you apply lube or after you have touched your partner or yourself with lube filled fingers, you will want to wipe your hands off. While most water-based lubricants will wash out of your sheers, you will still want to keep a hand towel close by.
If you have sex when traveling, tucking a small towel into your luggage to make sure there is one available is a good option. Including a regular hand towel you keep in your overnight bag if you travel back and forth to see a partner is also a good call.
About the author
Rebecca Blanton, aka Auntie Vice, is a writer and kink educator. She holds a Ph.D. (abd) in Political Psychology and a BA in Psychology.
Their work focuses on gender, power, and kink//BDSM. She runs the award-winning blog LoveLettersToAUnicorn.com and has published several books, including The Big Workbook for Submissives, a finalist for the 2018 Golden Flogger Award. She has taught about kink and submission for the past seven years.
She regularly performs stand-up and storytelling. Prior to turning her attention to kink education and writing, she served as the Executive Director for the California Commission on the Status of Women and Girls and worked as a Senior Policy Analyst for the California Research Bureau.