Name: Vaginal dryness
Creator: Dr Karen Martin
Published: 2023-02-15T11:53:32.369Z

If methods you have tried at home are not working, or the symptoms are really affecting you, if you have bleeding from the vagina or bleeding after sex, then book an appointment with your doctor. 

When should I see my doctor?

If your symptoms are caused by low estrogen levels, as in menopause, your doctor may suggest estrogen replacement cream. This can be applied directly to the vagina and surrounding genital area to help improve your symptoms. Depending on your preference, this also comes in the form of a small flexible ring, an applicator like a small tampon, and a cream. Topical estrogen is not recommended if you have breast or endometrial cancer, are pregnant, are breastfeeding, or have unexplained vaginal bleeding. 

What can my doctor do?

The hormone estrogen helps keep the lining of the vagina moist and supple. Vaginal dryness is commonly affected by things that change or affect your hormone levels, such as the contraceptive pill, breastfeeding, [menopause](https://www.healthwords.ai/us/article/menopause!a42df3ea-458d-4374-8f07-1bf83255b984), or having your womb removed ([hysterectomy](https://www.healthwords.ai/us/treatment/hysterectomy!07613807-d90b-4f51-9f30-6375509c4e97)). Medical conditions like Sjogren's syndrome can also cause it.

Medications, including [antidepressants](https://www.healthwords.ai/us/article/antidepressants-your-questions-answered!849229a1-c190-47d1-99f8-a9b76b55df49) and chemotherapy, can cause vaginal dryness. Lifestyle factors such as [smoking](https://www.healthwords.ai/us/article/smoking-vaping-and-the-risk-to-young-people!5eb88bb9-5914-474a-8a54-934e5fd4dc31), exercising excessively, [stress](https://www.healthwords.ai/us/article/stress!b1b907f1-6bd9-4b83-a41c-7d28b583e498), and using perfumed or scented soaps or washes around the vagina can add to the dryness.

What causes vaginal dryness?

Replens Long-lasting Vaginal Moisturizer With Reusable Applicator, 14 Applications

Replens Vaginal Moisturizer With Pre-Filled Applicators (8-Applications)

It is best to stop smoking, avoid stress and avoid perfumed or scented products in and around the vagina. Although tempting to ease discomfort, oil-based products like Vaseline or petroleum jelly inside the vagina carry the risk of infection and can prevent condoms from working properly.

You can use products specifically made for the vagina, like vaginal moisturizers, to help improve moisture levels. Water-based lubricants also help improve your symptoms during sex to make it more enjoyable.

How can I manage vaginal dryness myself?

Lichen sclerosus is a skin condition in which you might notice the area feels tight or itchy. It may be painful when passing urine, having sex, or – for men – getting an erection. If it's around the anus, you may find it sore when passing a stool.

Skin can become fragile and bleed if rubbed or scratched and then feel very sore if it breaks down. It may form blood blisters or thickened areas with constant scratching. At first, there may be nothing to see on the skin. Later in the process, you may notice shiny white patches where it feels sore or itchy.

Candidal Skin Infection Symptoms, Causes, and Treatments

Candida is a very common yeast causing a thrush infection. This gives rise to itching and soreness on the skin around the genitals and sometimes pain when passing urine. Warm damp conditions allow the yeast to grow, leading to a distinct bright red rash, often with small red bumps or pus-filled bumps around the edge. Soreness rather than itchiness distinguishes it from other causes of rash. 

This is more common in women than men and affects the labia (the outer and inner lips to the vagina), but it can spread to the groin and can cause itching and irritation to the inside of the vagina. You may also experience vaginal discharge, which is typically thick, white, and doesn't have any particular smell. Most people know it as thrush, but it's medically termed candidiasis or candidal vulvovaginitis if it affects the vagina. 

In men, this can affect the penis, causing candidal balanitis, and may cause some pain in passing urine. 

Menopause – can I buy HRT from the pharmacy?

Menopause is individual to every woman, and treatment should be tailored to her individual symptoms and concerns as she goes through the change in hormones from her late 40s onwards.   

Every woman goes through it, but everyone experiences different symptoms and to varying degrees of severity.   

Previously women would book an appointment with their doctor to discuss symptoms and treatment options. Still, some women have researched and already think that Hormone Replacement Therapy (HRT) is right for them.  

Endometriosis is a condition in which tissue similar to that lining the uterus (womb) grows outside of the womb, which can cause pain and other symptoms. The exact number of women with endometriosis is unclear because there are sometimes no symptoms, but about 10% of women in the US are affected and it also frequently runs in families. It’s rare in women after menopause. The endometrium consists of glands, lots of blood vessels and other supportive tissues and during the menstrual cycle hormones cause the endometrium to thicken in order to nourish an embryo if a pregnancy occurs.

Endometriosis is an inflammatory condition where there is repetitive irritation from the deposits that are present outside of the womb. These deposits vary greatly in size from tiny to large, can cause inflammation, and eventually scarring. This causes parts of pelvic organs to stick together, increasing the sensitivity of nerves and leading to chronic pain. The cervix (the neck of the womb) is commonly affected.

[Vaginal dryness](https://www.healthwords.ai/us/article/vaginal-dryness!98a7500c-8c36-418f-977d-ca6f2e11d199) is a common problem that many women have at some point in their lives. It can affect women of all ages, but it is far more common in women who are post-[menopausal](https://www.healthwords.ai/us/article/menopause!a42df3ea-458d-4374-8f07-1bf83255b984). It affects around 2 in 10 women under the age of 50.

The symptoms of vaginal dryness can cause you to feel sore or itchy in and around your vagina. You may also feel pain or discomfort during sex and may need to pee more often than usual. Many of the symptoms of vaginal dryness can also be mistaken for other common infections, such as [thrush](https://www.healthwords.ai/us/article/thrush!5c45a1cb-035f-4eac-a6b3-149d9e716ffe) and [urinary tract infections (UTIs)](https://www.healthwords.ai/us/article/urinary-tract-infection-\(uti\)!8933d49c-2592-4a51-ae8b-12940b6402b4). Vaginal dryness can also increase your risk of recurrent UTIs.

Dry skin – sometimes called **xerosis** by doctors - is a condition (not necessarily a disease) where the skin is red, scaly and itchy. The problem is usually worse in autumn and winter, and dry skin is most common on the face, hands, arms and legs. As we age, dry skin becomes more likely. It is not a serious problem usually, but can be uncomfortable and unsightly. Ageing, living in dry, cold or low-humidity climates and bathing or showering frequently make it more likely to occur. It affects both sexes, and is more common in Caucasian skin than those whose skin has a higher oil content, such as with Afro-Caribbean or Mediterranean skin.

Dry skin can be intensely itchy. It feels rough and flakes easily. Cracks and redness can form in more severe cases. Children can be particularly at risk, and this may take the form of eczema - where inflammation of the uppermost layer of skin causes dryness, and this is most likely to appear on the insides of elbows or the backs of knees. Eczema may run in families or run alongside asthma or hay fever.

Dry skin is a variant of normal skin and is not contagious

Bacterial vaginosis (BV) is the most common cause of vaginal infection in women of child-bearing age - those between 15 and 44 years old. It isn’t classed as a sexually transmitted infection although it is more likely to occur if you’re sexually active, especially with a new partner, if you smoke, use a copper coil (IUCD) for contraception, use bubble baths or feminine hygiene products, or if you have heavy periods. Having BV can also increase your chances of developing a sexually transmitted infection. It’s estimated that 1 in 3 women have an episode of BV at least once in their life. 

BV is usually harmless and can be triggered by sex or your period. It’s due to a disturbance in the balance of bacteria in the vagina. Normally, this is well controlled with lots of ‘friendly’ bacteria (germs) which is normal but in BV the change in bacteria makes the vagina less acidic, encouraging growth of more bacteria called anaerobes that grow in an environment without air. It can also be triggered by over-washing or douching (washing inside of the vagina). This is because over-washing can clear away the ‘good’ bacteria, allowing for bad bacteria to grow. This is unnecessary as BV is not linked to poor hygiene or from being unclean. 

Vaginal thrush is a common condition caused by a [yeast infection](https://www.healthwords.ai/us/article/yeast-infection!3d3ce04e-5fcd-4cc3-a85e-889487b66f30) in the vagina and surrounding area. This infection is usually Candida albicans, and is also known as candida or vulvovaginal candidiasis.

Candida lives harmlessly on the skin, in the mouth, gut and vagina and is normally kept under control but if conditions change then the yeast increases rapidly, causing symptoms of discharge and irritation.

This is more common in women than men, and affects the labia (the outer and inner lips to the vagina), but can spread to the groin, and can cause itching and irritation to the inside of the vagina. You may also experience vaginal discharge, which is typically thick, white, and doesn't have any particular smell.

In men, this can also affect the penis, causing candidal balanitis, and may cause some pain on passing urine.

## Who gets thrush?

Most women get thrush at some point in their life, but it is most common in women in their thirties and forties, and in those who are pregnant. It is not clear why some women are more prone to thrush than others. [Diabetes](https://www.healthwords.ai/us/article/diabetes-mellitus!5599d723-d414-4fa7-a30d-843a7238b283) and medical conditions that cause problems with the body's immune system increase the likelihood of it occurring. Other potential triggers include wearing tight clothing that prevents natural ventilation, taking antibiotics (about 1 in 4 women will have thrush because of this), using products that irritate the vagina, such as vaginal douches or feminine hygiene products, and having chemotherapy. There is little evidence that using sanitary towels or tampons is a risk factor for developing thrush.

Although not usually thought of as a [sexually transmitted disease](https://www.healthwords.ai/us/article/sti-at-risk!3eb15c26-d0fe-4346-9ea7-94bf939ca2d0), thrush can sometimes be passed on to your partner after vaginal, oral or anal sex, during foreplay or by sharing sex toys.

Chlamydia is a very common sexually transmitted infection (STI). It is a bacterium that can spread in semen or vaginal fluid and infect the vagina, uterus (womb), urethra (tube for the passage of urine, plus semen in men), the penis, rectum and, less commonly, the throat and eyes.

It may cause no symptoms at all but if it does, signs to look out for are a vaginal, penile or rectal discharge. This is usually watery and white or cloudy, and there may also be pain or stinging when peeing. In the longer term, men may get pain in the testicles and women develop pain in the pelvis, especially when having sex, and bleeding after sex or between periods. Ultimately it can cause infertility if left untreated. It may also cause joint inflammation (reactive arthritis) and irritated red eyes (conjunctivitis).

Given the high stakes and the fact that you may have no symptoms at all, it’s important to get tested regularly. This is especially important if you are aged 16 to 25, as this is the highest risk age group. If you're a woman, sexually active and under 25, it's recommended that you have a chlamydia test once a year, and when you have sex with new or casual partners. If you're a man, sexually active and under 25 it's recommended that you have a chlamydia test once a year if you’re not using condoms with new or casual partners. Get an STI test at the change of any partner (use condoms until you both get the all-clear) and if you’re changing partners regularly or have multiple partners, get tested every three months.

Clotrimazole is an antifungal medication and is used to treat common fungal infections like the organisms that cause vaginal thrush. Vaginal tablets are a way to treat the local area affected by inserting them directly into the vagina. Mycelex and Gyne-Lotrimin are branded versions of clotrimazole. Clotrimazole is available over the counter. Combination packs with clotrimazole cream are also available.

Labor for most women is very painful, and pain relief is usually required to help them through to prevent distress to themselves and their babies. 

Menopause is when you stop having periods. It can vary in how it occurs with some people experiencing gradually changing periods, or missed periods, and others finding a sudden end to their periods. Once you have had one year without a period it can be confirmed that you have gone through menopause. Natural menopause is due to increasing age, where over time your ovaries produce less of the hormone estrogen, which in turn means your ovaries don’t release an egg (so you can no longer conceive naturally) and your periods subsequently stop. It happens to all women; however, exactly when menopause occurs, and the symptoms people experience during this time, vastly differ.

For most women menopause occurs between the ages of 45 and 55, however, it can regularly occur earlier or later than this. One in 100 women will go through early menopause which is defined as occurring before they are 40. You may also experience menopause due to having had surgery to remove your ovaries, having radiotherapy around the area of your ovaries, some chemotherapy treatment, or certain medical conditions.

**Hot flushes** are the most common [menopause](https://www.healthwords.ai/us/article/menopause!a42df3ea-458d-4374-8f07-1bf83255b984) symptom, with 3 out of every 4 women experiencing the sensation across their face, chest and body. It can cause some to feel uncomfortable, with sweating, dizziness and possibly palpitations.

Hot flushes come on suddenly at any time, and can last a few seconds or several minutes. Their unpredictable and all-consuming nature means they carry a high cost in terms of self-confidence, as it can feel embarrassing at work or social events.

[**Night sweats**](https://www.healthwords.ai/us/article/night-sweats!118dbc88-b1cd-4793-bef1-422093acf0aa) are a particular feature, sometimes leaving the bed linen drenched. They add to [**insomnia**](https://www.healthwords.ai/us/article/insomnia!ce36b18d-15db-4cf0-96d8-91b8b448f355) that many menopausal women experience during the transition.

Do I need a blood test to confirm menopause?

Women are told to expect any number of symptoms with menopause, and that it could come rather uncertainly **between the ages of 45 and 55**. So it can feel reassuring to think there’s a test that can say you are definitely in menopause, as this can help explain any particular symptoms and point to treatment options.

But is a simple blood test that straightforward? It can be hard to interpret, and other factors can be more reliable to guide you on whether you are menopausal, such as your symptoms, your age, how regular your periods are, and even what age the women in your family experienced their menopause.

Irregular periods describe when you can't predict when your period will come, and the length of time between periods changes every month. Most women have their own "normal" - for most, this is a period every 28 days, but some women bleed every 21 days, others every 35 days - this is the range of "normal."

The number of days of bleeding may vary - most women bleed for 5 days, but between 3 and 8 days is considered normal. An app can help you keep track of your rhythm, so you can get to know what's normal for you.

Oligomenorrhea is the medical term for infrequent periods and can cause a great deal of anxiety and disruption. It also has consequences if you're planning on getting pregnant.

Irregular periods may coincide with [heavy bleeding](https://www.healthwords.ai/us/symptom/heavy-periods!42e274cb-994e-4409-80de-d8816458b8e2) or [painful bleeding](https://www.healthwords.ai/us/article/period-pain-relief!ef7e7d1c-e408-47b4-8504-8115afa09136).

Warts are small fleshy growths or bumps with a hardened dry top, most often flesh-colored, but can appear red if irritated. Several can appear in a cluster. 

Genital warts are sexually transmitted infections caused by the human papillomavirus (HPV) and spread by vaginal, anal, digital, and oral sex or sharing sex toys. They are not harmful and can disappear within a few months, but they can become irritated and sore if they rub or catch on clothing, and some people are bothered by their appearance. You also put your partner or partners at risk of contracting them if left untreated. 

Depending on their size or location, they may catch on clothes or feel a bit sore and sometimes itch or bleed. They may not cause you any bother. Or you may be bothered by your appearance, which can affect your confidence and, inevitably, intimate relationships. 

Dr Kandi - Sexual health testing

Bacterial vaginosis (BV) is the most common cause of vaginal infection in women of child-bearing age - those between 15 and 44 years old. It is not classed as a sexually transmitted infection (STI), although it is more likely to occur if you are sexually active, especially with a new partner. Having BV can also increase your chances of developing an STI. 

BV is usually harmless and can be triggered by sex or your period. It can also be triggered by over-washing or douching (washing inside of the vagina). This is because over-washing can clear away the good bacteria, allowing for harmful bacteria to grow. 

Gonorrhea is a common sexually transmitted infection (STI) caused by a bacteria called Neisseria gonorrhoeae. This can easily pass from person to person via unprotected vaginal, anal, and oral sex or sharing of sex toys. Condoms help to prevent catching gonorrhea.  

This may cause no noticeable symptoms, or it can cause a yellow/green, watery, or pus-like discharge from the penis, vagina, or rectum. It may cause pain on peeing; for women, pain during sex, bleeding after sex, or bleeding between periods, and for men, pain in the testicles. It can cause joint inflammation (reactive arthritis) and eye symptoms (conjunctivitis) and, if left untreated, can cause infertility.  

Given the high stakes and the fact that you may have no symptoms, it’s important to get tested regularly. This is especially important if you are 16 to 25, as this is the highest-risk age group. Get an STI test at the change of any partner (use condoms until you both get the all-clear) and at least once a year.

Emergency contraception is given to those who have had unprotected sex, are not taking regular contraception, and want to avoid pregnancy. It’s commonly known as the morning-after pill, but this isn’t accurate, as it's available for up to 5 days after any unprotected sex. But the sooner it’s taken, the more effectively it prevents pregnancy.  

It’s important to emphasize that this is not an abortion or the termination of an embryo or fetus. The pill delays the release of a woman's egg, and the coil creates a hostile environment for sperm to fuse with a woman’s egg. It prevents a pregnancy rather than ending pregnancy.  

Your local sexual health clinic is best for all types of emergency contraception, but tablets are available on prescription from your doctor, the emergency department, and some pharmacies.  

Electronic cigarettes (e-cigarettes) or vapes have become a popular substitute for smoking in recent years. They offer two ways to help [stop smoking](https://www.healthwords.ai/us/treatment/stop-smoking-aids:-replace-nicotine-reduce-cravings!04317a55-7b85-402b-a3cd-9f06f66eb631): they give you something to hold and draw on, imitating a cigarette, and they can provide nicotine as an alternative means of replacement.

But e-cigarettes are still relatively new, and research is ongoing to determine their safety, whether they are effective at helping people to stop smoking, and to accurately quantify how much less harmful than tobacco cigarettes they are.

While it’s too early to define the long-term effects, they are thought to pose less of a risk than cigarettes. They may act as a useful stop-smoking aid alongside guidance in changing your behavior patterns. This is to cut down and hopefully stop for good, but the US Food and Drug Administration (FDA) has not approved e-cigarettes as a quit-smoking aid.

Studies show that you are far more likely to quit smoking with specialist support, and they help you through every step. They can advise on e-cigarettes and arm you with the knowledge of finding the safest products, how to use them, and when to wean yourself off them.

[Nicotine replacement therapy](https://www.healthwords.ai/us/article/nicotine-replacement-therapy-\(nrt\)!9915760a-c96d-4c29-a53e-3b401f00653d) (NRT), such as skin patches, lozenges, gum, or breath sprays, may be helpful. NRT can be given alone or alongside drug treatments such as varenicline and Zyban (bupropion hydrochloride).

The cervix is known as the neck of the womb and is a narrow muscular opening connecting the vagina to the womb (uterus). Cancer can affect any part of the cervix.

Cervical cancer is most commonly caused by certain strains of a virus called the Human Papilloma Virus (HPV).

The risk of cervical cancer has been much reduced with both the US’s [cervical screening](https://www.healthwords.ai/us/article/cervical-cancer-screening!81f390da-5d7a-4b04-a9cf-220cac9846e9) program and the HPV vaccination program. It's a relatively uncommon cancer but receives a lot of attention as it is so easily prevented if early cell changes are caught and because it affects young women who are otherwise healthy and at low risk of other [cancers](https://www.healthwords.ai/us/article/cancer!48b81296-8811-48f8-95f1-4f693150bc2e).

The womb is a pear-shaped female organ in your pelvis where a baby grows during pregnancy. It’s mostly muscular, and its lining is called the endometrium. 

Endometrial cancer begins in the lining of the womb and can then spread to the body of the womb and is sometimes referred to as uterine cancer. When discovered early enough, removal of the womb can cure the cancer. 

It’s the 4th most common cancer in women in the US with over 65,000 women developing it each year. Most cases occur over the age of 50 with the peak incidence being between the ages of 75 and 80. Most women get symptoms and therefore present at an early stage, giving a good chance that any treatment will succeed. The chances of survival are fairly good, and – taking into account all the different levels of endometrial cancer - more than 81% survive 5 years or more. 

Libido (sex drive): What is it & what affects it?

Libido refers to your sex drive. Normal levels of libido and sex drive are different for each person, there is no standard that anyone should be compared to. Loss of libido is a type of sexual dysfunction and means a drop in your normal sex drive (not just lower than another person's).

It is a common thing for people to experience. It can be due to many different things, such as fatigue, [stress](https://www.healthwords.ai/us/article/stress!b1b907f1-6bd9-4b83-a41c-7d28b583e498), symptoms of mental health conditions like [depression](https://www.healthwords.ai/us/article/depression!26bd2fdb-787a-4dd6-815e-abdc51a35cae), difficult personal circumstances, relationship difficulties, physical health conditions, or side effects of certain medications.

A hysterectomy is a surgical procedure undertaken to remove a woman’s uterus. There are many reasons why people get hysterectomies, and it is a common procedure. Once the uterus is removed, a woman will no longer have periods and will not be able to get pregnant.


Dr Karen Martin

Pharmacist and Head of US Content

Vaginal dryness is when your vagina feels sore, itchy, or painful. This can cause discomfort when having sex or passing urine. It’s a common problem and can be caused by a number of conditions, medications, and lifestyle factors. It’s not often a symptom of serious concern, and there are several ways to prevent, manage and treat the symptoms. 

Vaginal dryness

What causes vaginal dryness?

How can I manage vaginal dryness myself?

Pharmacist recommended products

When should I see my doctor?

What can my doctor do?

Related topics

Lichen sclerosus

Candidal Skin Infection Symptoms, Causes, and Treatments

Menopause – can I buy HRT from the pharmacy?

Endometriosis

Treating vaginal dryness

Dry skin

Bacterial vaginosis

Vaginal thrush

Chlamydia

Clotrimazole vaginal

Pain relief in labor

Menopause

Relief from menopausal flushes

Do I need a blood test to confirm menopause?

Irregular periods

Genital warts

BV

Gonorrhea

Emergency contraception

Vaping and e-cigarettes

Cervical cancer

Endometrial cancer

Libido (sex drive): What is it & what affects it?

Hysterectomy