Vaginal dryness after menopause: why it doesn’t resolve on its own and what you can do

The reason lies in the drop in oestrogen levels. You might already notice it during perimenopause: your vagina feels drier because your oestrogen levels begin to fluctuate and gradually decline. This can become even more pronounced during and after menopause, as your oestrogen levels remain low.

Oestrogen plays a crucial role in maintaining vaginal health. Here’s how it influences vaginal dryness. In short, a drop in oestrogen can lead to:

• Reduced blood flow to the mucous membrane, causing it to dry out more quickly.
• Thinner and less elastic vaginal walls, which exacerbate dryness.
• Decreased natural lubrication, making irritation or pain (e.g., during intercourse) more likely.
• A change in pH levels, as fewer lactobacilli are present to maintain the vaginal acidity balance.

About one-third of women going through menopause experience vaginal dryness. While this is normal, it can still be bothersome. The way these symptoms manifest varies from woman to woman. Some may experience more itching, others may feel pain during everyday activities like cycling, and some may have pain or even bleeding during sex.

However, vaginal dryness isn’t the only issue you might face during menopause. Hormonal changes in your body can lead to other vaginal symptoms, such as:

• Pain during urination: The decrease in oestrogen can cause the urethra to become drier, leading to pain during urination.
• Recurring infections: Changes in vaginal pH levels make you more susceptible to infections, such as urinary tract infections and vaginal yeast infections.
• Reduced libido: If your vagina feels dry, sex may become less enjoyable, which can naturally lead to a decreased desire for intimacy.
• Frequent urge to urinate: Oestrogen supports vaginal muscles and tissues. When oestrogen levels drop, these muscles can weaken, potentially causing prolapse and frequent urination.
• Urinary incontinence: Reduced blood flow and less elastic vaginal walls can put more pressure on your bladder, leading to involuntary urine leakage, for example, when coughing or laughing.

Many menopausal symptoms naturally subside once your body adjusts to lower hormone levels after postmenopause. Unfortunately, this is not the case for vaginal dryness. After menopause, your oestrogen levels remain low, meaning vaginal dryness usually persists. While good care or lubricants can help relieve the symptoms, the underlying cause does not disappear.

Additionally, your body changes as you age. The mucous membrane naturally becomes drier and less elastic, which can worsen vaginal dryness symptoms. Health conditions such as diabetes or autoimmune diseases, which are more common as you age, or the use of certain medications (like antidepressants or antihistamines), can also exacerbate the symptoms.

Since vaginal dryness often doesn’t resolve on its own after menopause, it’s especially important to provide your body with the right support in time. Try the following:

• Use water-based lubricants (during intercourse). These can relieve vaginal dryness and make intimacy enjoyable again.
• Pay attention to your diet to support vaginal health. Ensure you get enough vitamin E, which can be found in nuts, seeds, whole grains, avocados, and leafy green vegetables. This helps protect and hydrate your mucous membranes. Essential fatty acids, such as those in fatty fish (like salmon and mackerel), flaxseeds, chia seeds, and walnuts, also help maintain the right moisture balance. Zinc and proteins aid in repairing vaginal tissues.
• Exercise daily. Whether it’s walking or another form of physical activity, exercise improves blood circulation, which is essential for healthy vaginal tissues and helps keep your vagina hydrated.
• Stay hydrated. This might not come as a surprise, but drinking enough water or herbal tea helps keep your vaginal tissues better hydrated.
• Try natural remedies like maca and sea buckthorn oil. Maca can support hormonal balance, and sea buckthorn oil hydrates your skin. Add maca to your smoothie or take it as a capsule, and sea buckthorn oil is available in oil or capsule form.

• Smoking: Smoking reduces blood flow throughout your body, including to your vaginal mucous membranes. Less blood flow means less oxygen and nutrients, which can make your mucous membranes thinner and drier, worsening the discomfort.
• Soap, scented products: Your vaginal flora is balanced thanks to good bacteria and a natural protective layer. Soap and scented products can disrupt this balance, increasing irritation and dryness.
• Tight clothing: Tight clothing can cause friction and create a warm, moist environment, which can irritate your skin. Opt for breathable fabrics like cotton and wash your intimate area with water only.
• Excess sugar and refined carbohydrates: Sugar and refined carbs feed harmful bacteria and yeast, disrupting the balance in your vagina. This can not only lead to more dryness but also increase the risk of yeast infections or irritation.
• Consider a local oestrogen cream: If you’re experiencing significant pain and dietary or lifestyle adjustments aren’t enough, local hormone therapy can help temporarily replenish oestrogen levels and relieve vaginal dryness.