Vaginal dryness treatment (genitourinary syndrome of menopause)

Vaginal dryness after menopause is common and treatable. It is part of the genitourinary syndrome of menopause (GSM), which affects an estimated 27% to 84% of postmenopausal women. Unlike hot flashes, it often gets worse over time without treatment. Moisturizers, lubricants and low-dose vaginal estrogen help many women.

Key facts

  • GSM is the medical name for vaginal, vulvar and urinary changes caused by low estrogen. An older name is vaginal atrophy.
  • It is thought to be underdiagnosed and undertreated. Many women never mention it to a clinician.
  • For mild symptoms, over-the-counter vaginal moisturizers and lubricants are often enough.
  • For moderate to severe symptoms, low-dose vaginal estrogen, vaginal DHEA (prasterone) and the pill ospemifene are effective options.
  • With low-dose vaginal estrogen, very little hormone reaches the bloodstream, and a progestogen is not usually needed.
  • There is not yet enough evidence to recommend vaginal laser treatment.

What causes vaginal dryness?

The main cause is lower estrogen. Without it, the tissue of the vagina and vulva becomes thinner, drier and less stretchy. This often happens:

  • in perimenopause and after menopause;
  • after surgery that removes both ovaries;
  • with some breast cancer, endometriosis, fibroid or fertility medicines;
  • after chemotherapy or pelvic radiation;
  • after childbirth and while breastfeeding.

Scented soaps, douches, lotions and some detergents can make irritation worse. Smoking may also play a part.

What are the symptoms of GSM?

  • vaginal dryness, itching or burning;
  • pain or light bleeding with sex;
  • burning when you urinate;
  • needing to urinate more often or urgently;
  • urinary tract infections that keep coming back.

Other conditions, such as infections or skin conditions of the vulva, can cause similar symptoms. That is why an exam is helpful before you start treatment. Any bleeding after menopause should always be checked.

Vaginal dryness treatment options

Without a prescription

  • Vaginal moisturizers are used every few days, not just before sex. They help keep tissue moist for longer.
  • Lubricants are used during sex to reduce friction and pain. Water-based or silicone-based lubricants are good choices. Oils and petroleum jelly can damage latex condoms and diaphragms.
  • Avoiding irritants, like scented soaps, sprays and douches.

With a prescription

  • Low-dose vaginal estrogen. Comes as a cream, tablet, insert or ring. It treats the tissue directly and may also lower the chance of repeat urinary tract infections.
  • Vaginal DHEA (prasterone). A nightly vaginal insert.
  • Ospemifene. A daily pill that acts like estrogen on vaginal tissue. It has its own risks, including hot flashes and blood clots, and is not for everyone.
  • Systemic hormone therapy. If you also have hot flashes, HRT may help both. Some women still need vaginal treatment as well. See our HRT page.

Is vaginal estrogen safe?

For most women, low-dose vaginal estrogen is considered low risk because so little reaches the bloodstream. In February 2026, FDA approved label changes for several menopause hormone products, including a vaginal estrogen product, that removed heart disease, breast cancer and dementia statements from the boxed warning.

If you have had breast cancer, there is not enough data to confirm the safety of vaginal estrogen, DHEA or ospemifene. Your plan should be made together with your oncologist.

Are there natural treatments for vaginal dryness?

Many searches ask about natural remedies. Non-hormonal moisturizers and lubricants are the main evidence-based option without a prescription, and they help most women with mild symptoms. Be careful with oils, herbal products and "vaginal rejuvenation" claims. Some can irritate the tissue or damage condoms, and none has better evidence than the options above.

What to expect at your visit

Talking about vaginal dryness can feel awkward. It is a routine medical topic for an OB/GYN. Leticia Vargas, MD, OB/GYN, will ask about your symptoms, sexual health, bladder symptoms and medicines. A gentle pelvic exam may be recommended to rule out other causes. The first conversation can sometimes happen by telehealth if you are located in Texas, but an exam needs an in-clinic visit in San Antonio.

What to ask your clinician

  • Are my symptoms from GSM, or could it be an infection or skin condition?
  • Should I start with a moisturizer, or would a prescription work better for me?
  • Which form of vaginal estrogen would suit me?
  • How long until I notice a difference?
  • Is vaginal estrogen safe with my health history?
  • Could treatment help my bladder symptoms or repeat UTIs?

FAQs

Does vaginal dryness go away on its own after menopause? Usually not. Unlike hot flashes, GSM symptoms often continue or slowly get worse without treatment.

What is the difference between a vaginal moisturizer and a lubricant? A moisturizer is used regularly, every few days, to keep tissue moist. A lubricant is used during sex to reduce friction.

Can vaginal dryness happen before menopause? Yes. It can happen in perimenopause, after childbirth, while breastfeeding, or with some medicines.

Do I need progesterone with vaginal estrogen? With low-dose vaginal estrogen, a progestogen is usually not needed. Long-term studies beyond one year are limited, so tell your clinician about any bleeding.

Does vaginal laser work for dryness? There are not yet enough good studies to know if vaginal laser works or is safe. It is not a recommended treatment at this time.

Book a visit

Talk with Leticia Vargas, MD, OB/GYN, about vaginal dryness. Call (210) 903-1030 or book a visit. In-clinic in San Antonio • Telehealth for women located in Texas Yaso Wellness Health Clinic, 1907 Goliad Rd, San Antonio, TX 78223

About the clinician: Leticia Vargas, MD, OB/GYN, founder of Yaso Wellness Health Clinic. About Dr. Vargas

Sources

Education only, not medical advice or a diagnosis. In an emergency, call 911.