Vaginal Dryness: 10 Common Causes (& What to Do)

Vaginal dryness can be caused by normal changes that occur during breastfeeding or menopause, but it can also happen with allergies to vaginal hygiene or with health conditions, such as amenorrhea or Sjogren's syndrome.

Depending on its cause, vaginal dryness may be accompanied by other symptoms, such as vaginal burning, discomfort, pain during sex, or even recurrent UTIs and yeast infections.

If you notice persistent vaginal dryness, it is important to consult a gynecologist for assessment and diagnosis, which will help to guide the most appropriate treatment.

What causes vaginal dryness?

The main causes of vaginal dryness are:

1. Menopause

Vaginal dryness is a symptom that some menopausal women experience due to a decrease in estrogen production in the ovaries. This results in a change in the lining of the vaginal canal and a decrease in mucus production that keeps the vagina lubricated.

In addition to vaginal dryness, other symptoms that may appear include pain or discomfort during sex, itching in and around the vagina or the urge to urinate frequently.

What to do: You should consult a gynecologist who may recommend hormone replacement therapy with tablets, or the use of vaginal estrogen in the form of a cream or gel. These treatments should only be carried out if prescribed by a gynecologist, as they are contraindicated for women with an increased risk of breast, uterine or ovarian cancer, or thrombosis.

2. Breastfeeding

Breastfeeding can also cause vaginal dryness in some women. It occurs due normal hormonal changes that occur, like the increase in prolactin to stimulates breast milk production and decrease in estrogen and progesterone.

What to do: Vaginal dryness during breastfeeding is temporary and treatment is usually not necessary. Normal vaginal lubrication usually improves a few months after giving birth once ovulation restarts.

3. Irritation

Vagina hygiene products used when bathing may contain chemical substances that can cause irritation in some women, and lead to dryness and redness.

Underwear made with synthetic fabrics are also more prone to causing vaginal dryness and irritation.

What to do: if you have started using a hygiene product and notice vaginal dryness, discontinue use and monitor for improvement. You should also opt for cotton-based underwear and fabrics whenever possible. If there is no improvement, you should consult a gynecologist for assessment.

4. Excessive anxiety

Anxiety is a natural and very common feeling that is experienced during various stages of life. However, excessive anxiety can be harmful and impair normal bodily functions. 

Some women may experience a decrease in libido as a result, leading to decreased vaginal lubrication and dry mucus membranes.

What to do: In these cases it is recommended to use strategies that help cope with anxiety. Excessive anxiety should be assessed by a psychologist and treated.

5. Lack of stimulation

In these cases, vaginal dryness appears mainly during moments of sex, and can cause intense discomfort during penetration.Vaginal stimulation during sex is important to trigger natural lubrication in the vagina, as it can prevent dryness and pain during sex.

What to do: A great strategy to prevent dryness in these cases is to increase foreplay time before further intimate contact. This can increase libido and trigger more lubrication. Otherwise, women can opt for lubricating gels for use during sex to relieve discomfort.

6. Amenorrhea

Vaginal dryness can also be caused by hypothalamic amenorrhea. This condition is characterized by a lack of menstruation due to a disorder in the production of gonadotropin-releasing hormone (GnRH), which stimulates estrogen and progesterone in the ovaries to regulate the menstrual cycle.

This type of amenorrhea can be caused by stress, excessive physical activity or low body weight.

What to do: Treatment for hypothalamic amenorrhea should be directed by a gynecologist, and may involve reducing intense and frequent physical activities, an assessment with a registered dietitian and/or psychotherapy. In addition, the doctor may prescribe hormonal treatment to regulate hormonal levels.

7. Use of medicines

Some medication can cause dry mucus membranes a side effect, and can equally affect the genital area. These include antihistamines and asthma medications.

What to do: If you notice vaginal dryness after starting a new medication, you should advise the prescriber to determine whether an alternative medication is advisable.

8. Sjögren's syndrome

Sjögren's syndrome is an autoimmune disease, characterized by inflammation of some glands in the body, which can result in vaginal dryness, in addition to dry skin and a dry mouth.

This syndrome can be caused by changes in immunity or autoimmune diseases, such as rheumatoid arthritis, lupus, scleroderma, vasculitis, or chronic hepatitis.

What to do: Treatment should be guided by a rheumatologist, who may prescribe hyaluronic acid gel to treat vaginal dryness.

9. Ovarian removal surgery

Surgical removal of the ovaries, also known as oophorectomy, can lead to vaginal dryness. The absence of one or both ovaries leads to reduced estrogen production, leading to symptoms similar to menopause.

This surgery may be recommended by the doctor in cases of ovarian abscesses, cysts or abnormalities indicative of cancer, where one or both ovaries may be removed.

What to do: You should regularly consult and follow up with your gynecologist. Treatment typically involves hormone replacement therapy if there are no contraindications for it.

10. Cancer treatment

Cancer treatment, such as radiation therapy to the pelvic region, chemotherapy or hormone therapy for breast or uterine cancer, for example, can cause vaginal dryness and other symptoms such as nausea, vomiting, diarrhea, hot flashes or vaginal bleeding or discharge.

What to do: Follow-up with an oncologist, who may recommend the use of water-based vaginal lubricants, or vaginal estrogen in some cases.