What Causes Vaginal Dryness and How Is It Treated? Symptoms, Causes and Treatment Options

What Is Vaginal Dryness?

Vaginal dryness is a common health problem that occurs when the vagina loses its natural moisture, and it can affect your quality of life. The inner surface of the vagina is normally moist, elastic and slippery. This moisture is maintained by hormones, blood flow and healthy vaginal tissue.

Reduced moisture does not only cause discomfort during sex. It can also cause burning, irritation and stinging in everyday life, even while sitting, walking or exercising.

Although vaginal dryness can occur at any age, it is more common during breastfeeding after childbirth, during menopause and with certain hormonal changes.

What Are the Symptoms of Vaginal Dryness?

Vaginal dryness can feel different from person to person. The most common symptoms are:

• A feeling of dryness in the vagina
• Burning or stinging
• Itching
• Pain during sex
• Tenderness after sex
• A feeling of vaginal irritation
• Discomfort from friction during daily activities
• Tightness at the vaginal entrance
• A feeling of recurring urinary tract infections
• Frequent urination or a burning sensation when urinating

These symptoms may not be caused only by vaginal dryness. Similar complaints can also come from other causes such as infections, skin conditions or overly tense pelvic floor muscles.

What Causes Vaginal Dryness?

There is no single cause of vaginal dryness. Most of the time, hormonal, mechanical and lifestyle factors play a role together.

1. Lower estrogen levels

The most common cause of vaginal dryness is a drop in estrogen levels.

Estrogen is the key hormone that supports:

• the thickness of vaginal tissue,
• its elasticity,
• blood flow,
• natural moisture production.

It plays a central role in vaginal health.

When estrogen decreases, vaginal tissue can become thinner, more sensitive and drier.

2. Breastfeeding

In women who breastfeed after childbirth, estrogen levels can drop temporarily as the hormone prolactin rises.

That is why many women experience the following while breastfeeding:

• vaginal dryness,
• pain during sex,
• a burning sensation.

These are common complaints.

This is usually related to breastfeeding and is temporary for many women.

3. Menopause

Vaginal dryness is very common during menopause because the ovaries produce less estrogen.

Along with dryness, you may notice:

• burning,
• itching,
• a frequent urge to urinate,
• pain during sex.

These symptoms often appear together.

4. Certain medications

Some medications can also cause vaginal dryness.

For example:

• some birth control methods,
• some allergy medications,
• some antidepressants,
• some hormonal treatments

can reduce vaginal moisture.

If you take medication, talk to your doctor instead of stopping it on your own.

5. Overly tense pelvic floor muscles

Most people do not know this.

Sometimes the problem is not actually vaginal dryness.

When the pelvic floor muscles stay constantly tightened, blood flow to the area can decrease and you may feel dry. Burning, stinging and friction during sex can also increase.

Assessing the pelvic floor muscles is especially important in people who describe a feeling of dryness even though no obvious dryness is found on examination.

6. Stress and anxiety

Intense stress, anxiety and fear of pain during sex can have a negative effect on arousal.

When arousal is insufficient, natural vaginal lubrication can also decrease.

7. Insufficient sexual arousal

Natural vaginal lubrication is part of sexual arousal.

Too little foreplay, fear of pain or psychological factors can reduce lubrication.

Why Does Vaginal Dryness Make Sex Painful?

When the vagina is not moist enough, friction increases.

As a result, you may develop:

• burning,
• stinging,
• irritation,
• pain during sex,
• tenderness after sex.

These can make intimacy uncomfortable.

Some women involuntarily tighten their pelvic floor muscles because of this pain. Over time, this can turn into a vicious cycle and the pain can persist.

How Is Vaginal Dryness Treated?

Treatment should be planned according to the cause of the dryness.

The same treatment is not right for everyone.

Identifying the underlying cause

The first step is to find out what is causing the dryness.

Hormonal changes, infections, dermatological conditions, the pelvic floor muscles and any medications you take should all be evaluated together.

Vaginal moisturizers and lubricants

Vaginal moisturizers or water-based lubricants, used as recommended by your physician, can reduce discomfort, especially during sex.

Hormonal treatments

For some people in menopause or with a significant estrogen deficiency, a doctor may recommend local (vaginal) estrogen treatment.

These treatments are not suitable for everyone and must be planned by an obstetrician-gynecologist.

Pelvic floor physiotherapy

For women who feel vaginal dryness, the problem may not be hormones alone.

Pelvic floor physiotherapy can include an individually planned combination of:

• assessment of the pelvic floor muscles,
• evaluation of the muscles' ability to relax,
• assessment of breathing patterns,
• manual therapy,
• relaxation exercises,
• a home exercise program.

Each element is tailored to you.

Assessing the pelvic floor muscles is especially important if you also have burning, stinging or pain during sex.

Does Vaginal Dryness Prevent Pregnancy?

Vaginal dryness on its own is generally not a cause of infertility.

However, it can reduce how often you have sex by making it painful, or it can be a sign of a hormonal problem.

That is why it is important to investigate the underlying cause, especially if you are planning a pregnancy.

When Should You See a Doctor?

It is recommended that you get evaluated if:

• The dryness has lasted a long time
• Sex has become painful
• You have bleeding
• You have severe burning or itching
• It comes with foul-smelling discharge
• It affects your daily life

Frequently Asked Questions

What causes vaginal dryness?

The most common causes are lower estrogen levels, breastfeeding, menopause, certain medications, stress and overly tense pelvic floor muscles.

Can you have vaginal dryness at a young age?

Yes. Vaginal dryness does not only happen in menopause. Breastfeeding, hormonal changes, certain medications and tense pelvic floor muscles can also cause a feeling of dryness in younger women.

Does vaginal dryness go away on its own?

It depends on the cause. Dryness related to breastfeeding can improve over time. However, if the symptoms last a long time, the underlying cause should be investigated.

Which doctor should you see for vaginal dryness?

For the initial evaluation, you can see an obstetrician-gynecologist. If the dryness comes with tense pelvic floor muscles or pain during sex, a pelvic floor physiotherapy assessment can also be helpful.

Does vaginal dryness cause pain during sex?

Yes. Reduced vaginal moisture can increase friction and cause burning, stinging and pain during sex.

Conclusion

Vaginal dryness is not a problem that only happens during menopause. It can also occur while breastfeeding after childbirth, with hormonal changes, with certain medications and when the pelvic floor muscles are overly tense. For treatment to succeed, the cause of the dryness must be identified first. With medical treatment planned according to the underlying cause, appropriate lifestyle advice and, when needed, pelvic floor physiotherapy, symptoms can be significantly reduced for many women.