Vaginal Dryness: Causes and What Helps at Any Age

Vaginal dryness happens at every age, not only after the menopause. The NHS lists pregnancy and breastfeeding, hormonal contraceptives and antidepressants, hysterectomy, cancer treatments, perfumed washes and not being aroused alongside falling oestrogen.¹ What helps depends on the cause: a vaginal moisturiser used regularly, a water-based lubricant for sex, and, when oestrogen is the reason, low-dose vaginal oestrogen from a GP or, for one tablet, a pharmacist.^{1, 2} It sits beside the Wellgard BV guide because dryness is not an infection.

What causes vaginal dryness at any age?

The NHS gives two lists. Hormonal: the menopause, pregnancy or breastfeeding, "certain medicines such as hormonal contraceptives or antidepressants", a hysterectomy and cancer treatments, which change hormone levels and so the fluid the vagina makes. Non-hormonal: not being aroused during sex, perfumed soaps, washes or douches, and a condition such as diabetes or Sjögren's syndrome.¹

Is it the menopause, the pill, breastfeeding or something else?

After a baby: in a US study of 2,748 first-time mothers, 21.2% reported painful sex at six months: 31.5% of those breastfeeding against 12.7% of those who were not.³ Low oestrogen while breastfeeding is the usual explanation; a midwife or GP is the first call if it does not ease as feeds reduce. On the pill or an antidepressant: the NHS lists both as causes; no review has measured dryness itself, and a prescribed medicine is never stopped without the prescriber.¹ In your forties and beyond: perimenopause is part of the same fall in oestrogen, and nearly half of women past the menopause report bothersome vulvovaginal symptoms.⁴ The over-50 detail, including the "thrush" that swabs negative, is on vaginal oestrogen after the menopause; the sleep side is on perimenopause sleep problems.

What is the difference between a vaginal moisturiser and a lubricant?

A moisturiser is a gel made for the vagina, used regularly whether or not you have sex, to hold water in the tissue for days; a lubricant is used during sex to reduce friction; many women use both.⁵ The NHS: "use water-based lubricants before sex", use vaginal moisturisers, and "do not use creams, lotions or moisturisers that are not for your vagina".¹

In a laboratory study of 14 shop-bought lubricants, six water-based gels were hyperosmolar, far more concentrated than the body's own fluid, and those reduced the viability of vaginal tissue and sloughed its surface cells, while near-iso-osmolar gels and both silicone products did not; no trial has tested a threshold in women.⁶ The NHS condoms page: "do not use oil-based lubricant with latex condoms".⁷ Hyaluronic acid vaginal gel has trials of its own: a 2026 pooled analysis of 11 randomised trials, three placebo-controlled, found better dryness-related quality of life and sexual function than placebo, with moderate certainty and possible publication bias; no trial of hyaluronic acid by mouth exists for dryness.⁸

Does coconut oil or any other oil help?

No trial has tested coconut oil or any other plant oil for vaginal dryness, so two facts and an absence. The facts: oils damage latex condoms, and the NHS says not to use products not made for the vagina because they can cause irritation or infection.^{1, 7} The absence: whether it can cause thrush has not been studied. Some women report comfort; the trials are silent.

What is vaginal oestrogen, and who prescribes it?

Vaginal (local) oestrogen is a small dose placed in the vagina as a cream, gel, tablet, pessary or ring, acting on the tissue it touches; HRT is the body-wide dose. In the 2016 Cochrane review of 30 randomised trials and 6,235 women there was no evidence of a difference in symptom improvement between ring, cream and tablets, and more women improved on the ring than on placebo in one 67-woman trial.⁹ The balance: in one 12-week trial of 302 women, a low-dose oestrogen tablet, a vaginal moisturiser and a placebo eased the most bothersome symptom to a similar degree; one trial with a strong placebo response does not overturn the review.⁴ NICE's 2024 recommendations: "Offer vaginal oestrogen to people with genitourinary symptoms associated with menopause"; serious adverse effects are very rare; "symptoms often return when vaginal oestrogen is stopped but treatment can be restarted"; it is absorbed locally; where it is contraindicated or not wanted, and first after breast cancer, consider non-hormonal moisturisers or lubricants.²

It is a GP prescription, with one exception: since 2022 a low-dose estradiol vaginal tablet has been available from UK pharmacies without a prescription, for women aged 50 and over who have not had a period for at least a year, after a pharmacist consultation.¹⁰ Two UTI facts: in a 1993 trial of 93 post-menopausal women with recurrent UTIs, vaginal oestriol cut infections from 5.9 to 0.5 a year and brought lactobacilli back in 61%;¹¹ oral HRT did not (Cochrane review, four studies, 2,798 women, relative risk 1.08), and NICE says "Do not offer systemic hormone replacement therapy specifically to reduce the risk of recurrent UTI".^{12, 13}

Is it dryness, thrush, BV or a UTI?

Dryness is a change in the tissue; the other three have their own tests and treatments. A UTI is a bacterial infection of the bladder or urethra: burning on passing urine, urgency and frequency, a urine sample, an antibiotic. Bacterial vaginosis is a shift in the vaginal bacteria: a thin grey discharge and a fishy smell, a swab, an antibiotic. Thrush is a yeast: itch, soreness and a thick white discharge, a swab, an antifungal. The ingredient evidence does not transfer: cranberry products reduced UTIs in women with recurrent infections (relative risk 0.74, Cochrane 2023) and have no BV or thrush trial;¹⁴ live cultures taken after antibiotics were associated with BV recurrence of 14.8% against 25.5% in ten trials of 1,234 women,¹⁵ and did not significantly reduce recurrent UTIs in the 2015 Cochrane review (relative risk 0.82; a benefit "cannot be ruled out");¹⁶ D-mannose, which the NHS says has "some evidence it may be helpful", was no better than placebo in a UK trial of 598 women (51.0% against 55.7%).^{17, 18} Is it thrush, BV or something else puts the conditions in one table; what your discharge means and vaginal odour cover the rest.

When should I see a GP about dryness?

The NHS says see a GP if dryness has lasted a few weeks and self-care is not working, if it affects daily life, if there is unusual discharge, or if you have "bleeding after sex, in between your periods or after experiencing menopause".¹ Bleeding after the menopause is always checked, promptly. In pregnancy or while breastfeeding, the midwife or GP comes first. Itch, white patches or skin changes need a GP and are covered on itching and soreness; pain during sex that a lubricant does not settle is a GP question; desire is on low sex drive and what the trials show. Dryness with hot flushes or bladder symptoms is worth a treatment conversation, since NICE says vaginal oestrogen should be offered;² menopause supplements with evidence grades the rest of the shelf.

Frequently asked questions

What is the best vaginal moisturiser?

One made for the vagina, used regularly, that you tolerate: water-based, unperfumed, and not far more concentrated than the body's own fluid.⁶ This site names no brands, so the answer is by type. Give it the few weeks after which the NHS says to see a GP if it has not helped.¹

How do you cure vaginal dryness?

The cause is addressed and the symptom is managed. Breastfeeding passes; a medicine is a prescriber's conversation; perfumed products are stopped; where falling oestrogen is the cause, a moisturiser and lubricant help and vaginal oestrogen is the treatment the NHS and NICE point to.^{1, 2}

Can you use a lubricant every day?

Yes. A moisturiser is designed for regular use and a lubricant for whenever sex happens; wanting lubricant daily outside sex is what a moisturiser is for.¹

Do live cultures or supplements help vaginal dryness?

No trial has measured dryness as an outcome for any supplement. The study sometimes quoted, 72 post-menopausal women taking two specific lactobacillus strains for 14 days, measured a Gram-stain score of the vaginal flora, not symptoms.¹⁹ Anyone immunocompromised, with a central line or seriously ill asks a pharmacist or GP before any live-culture supplement.

This article is general information, not medical advice; nothing here recommends a medicine. Bleeding after the menopause is always checked by a GP.

Sources

1. NHS. Vaginal dryness. Reviewed 24 July 2025. nhs.uk/conditions/vaginal-dryness.
2. NICE. Menopause: identification and management (NG23), section 1.5. Updated 15 April 2026. nice.org.uk/guidance/ng23.
3. Alligood-Percoco NR, et al. Risk factors for dyspareunia after first childbirth. Obstetrics and Gynecology, 2016. PubMed 27500349.
4. Mitchell CM, et al. JAMA Internal Medicine, 2018: randomised trial of vaginal estradiol, a vaginal moisturiser and placebo in 302 postmenopausal women. PubMed 29554173.
5. Edwards D, Panay N. Climacteric, 2016: review of vaginal lubricant and moisturiser composition in vulvovaginal atrophy. PubMed 26707589.
6. Dezzutti CS, et al. Is wetter better? An evaluation of over-the-counter personal lubricants for safety and anti-HIV-1 activity. PLoS One, 2012. PubMed 23144863.
7. NHS. Condoms. Reviewed 26 January 2024. nhs.uk/contraception/methods-of-contraception/condoms.
8. Dahab M, et al. Hyaluronic acid for vaginal health and quality of life in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. International Journal of Gynaecology and Obstetrics, 2026. PubMed 41773428.
9. Lethaby A, et al. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database of Systematic Reviews, 2016. PubMed 27577677.
10. MHRA. Press release, 20 July 2022: reclassification of a locally-applied HRT product to pharmacy supply. gov.uk.
11. Raz R, Stamm WE. A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections. New England Journal of Medicine, 1993. PubMed 8350884.
12. Perrotta C, et al. Cochrane Database of Systematic Reviews, 2008: oestrogens and recurrent urinary tract infection in postmenopausal women. PubMed 18425910.
13. NICE. Urinary tract infection (recurrent): antimicrobial prescribing (NG112), section 1.2. Updated 12 December 2024. nice.org.uk/guidance/ng112.
14. Williams G, et al. Cochrane Database of Systematic Reviews, 2023: cranberry products and urinary tract infections. PubMed 37068952.
15. Chieng WK, et al. Frontiers in Nutrition, 2022: meta-analysis of ten trials of live cultures and BV recurrence. PubMed 36204368.
16. Schwenger EM, et al. Cochrane Database of Systematic Reviews, 2015: live cultures and recurrent urinary tract infection in adults and children. PubMed 26695595.
17. Hayward G, et al. JAMA Internal Medicine, 2024: placebo-controlled trial of D-mannose in 598 UK women. PubMed 38587819.
18. NHS. Urinary tract infections (UTIs). Reviewed 11 July 2025. nhs.uk/conditions/urinary-tract-infections-utis.
19. Petricevic L, et al. Randomized, double-blind, placebo-controlled study of oral lactobacilli to improve the vaginal flora of postmenopausal women. European Journal of Obstetrics, Gynecology and Reproductive Biology, 2008. PubMed 18701205.