Vaginal Dryness: The So Often Overlooked Symptom During Menopause — and How to Make a Life-Changing Difference

By Dr Chris de Kauwe, GP, MBChB, MRCGP, Women’s Health Specialist, Registered BMS Menopause Specialist, Member of NAPS, TMC London

The Hidden Symptom of Menopause

When most people think of menopause, hot flushes, night sweats, and mood changes often top the list.
But one of the most common — and least talked-about — symptoms is vaginal dryness, affecting up to 80% of women.

This can significantly impact comfort, intimacy, and confidence, yet despite how common it is, many women never discuss it openly.
Some may not realise it’s linked to menopause, while others feel embarrassed to bring it up.

That’s why it’s essential for healthcare professionals to create a safe, open space for women to talk about this symptom — and to ask directly if it hasn’t been mentioned.

In this article, we’ll explore what causes vaginal dryness, what it feels like, and how treatments such as vaginal oestrogen can make a life-changing difference.

What Causes Vaginal Dryness?

Vaginal dryness during menopause is primarily caused by falling oestrogen levels.

Oestrogen keeps vaginal tissues soft, thick, and naturally lubricated. As levels decline during perimenopause and menopause, the vaginal lining becomes thinner, less elastic, and produces less natural moisture — leading to discomfort.

What Does Vaginal Dryness Feel Like?

Every woman’s experience is different, but vaginal dryness can feel like tightness, burning, itching, or friction in the vaginal area.
Some describe it as a persistent dryness or chafing sensation that worsens during activity or intimacy.

It can also lead to:

• Painful intercourse (dyspareunia)

• Soreness or stinging sensations

• Increased urinary urgency or mild burning when urinating

These symptoms can understandably affect confidence, relationships, and self-esteem — but the good news is, effective treatments are available.

Is There a Cure for Vaginal Dryness?

While there isn’t a permanent cure, there are highly effective treatments that restore vaginal health and moisture long-term.

The goal isn’t just to relieve symptoms — it’s to treat the underlying cause: low oestrogen.

For many women, vaginal oestrogen therapy provides lasting relief by replenishing local hormone levels directly where it’s needed.

The takeaway: vaginal dryness is treatable — you don’t have to “just live with it.”

What Is Vaginal Oestrogen and What Are Its Key Benefits?

Vaginal oestrogen is a localised hormone therapy designed to relieve symptoms of vaginal dryness during menopause.
It restores natural lubrication, elasticity, and comfort by replenishing oestrogen directly within vaginal tissues.

There are several options — available as creams, tablets, rings, or pessaries — allowing women to choose the method that best suits their lifestyle.

Key Benefits of Vaginal Oestrogen

• Relief of vaginal dryness symptoms

• Improved sexual health and confidence

• Reduced risk of recurrent urinary tract infections (UTIs)

• Healthier vaginal tissues and pH balance

• Low systemic absorption, minimising side effects

Many women notice improvement within a few weeks of starting. It can also be safely used alongside other HRT options.

Is Vaginal Oestrogen Safe?

Yes — vaginal oestrogen is safe for most women in the perimenopausal or postmenopausal stages.

Research shows that it has very low absorption into the bloodstream, meaning it doesn’t significantly raise overall hormone levels.
Unlike full-body HRT, it does not carry the small increased risk of breast cancer and is often suitable for women with a previous breast-cancer history.

However, always consult your healthcare provider before starting treatment to ensure it’s right for you.

Alternatives and Complementary Options

If vaginal oestrogen isn’t suitable, several other options can still help:

• Vaginal moisturisers and lubricants for daily or sexual comfort

• Systemic (full-body) HRT for broader menopausal symptom relief

• Lifestyle changes, such as staying hydrated, avoiding perfumed products, and maintaining regular sexual activity

Combining these approaches often provides the best results.

Vaginal atrophy and genitourinary syndrome of menopause (GSM)

Vaginal dryness is often part of a wider condition called vaginal atrophy, now usually known as genitourinary syndrome of menopause (GSM). Falling oestrogen thins, dries and inflames the vaginal walls. As well as dryness, symptoms can include itching, burning, pain during sex, urinary urgency, recurrent urinary tract infections and bleeding after sex.

Vaginal oestrogen also has positive effects on the urinary symptoms of GSM. Left untreated, GSM can cause ongoing discomfort and pain during sex, and the loss of elasticity in the tissues increases the risk of vaginal infections, urinary tract infections and urinary incontinence.

Key Takeaways

Vaginal dryness is one of the most common yet overlooked symptoms of menopause — but it’s also one of the most treatable.

Whether through vaginal oestrogen, natural lubricants, or other therapies, there are safe and effective solutions to restore comfort and confidence.

Remember, menopause is a natural transition — not the end of comfort or intimacy.
If vaginal dryness is affecting your quality of life, don’t suffer in silence.
Relief is not only possible — it’s well within reach.