Vaginal dryness after menopause: your options, from home care to prescriptions

Short answer: Vaginal dryness after menopause is common and treatable, but it rarely goes away on its own. Start with a vaginal moisturizer used a few times a week and a lubricant for sex. If that is not enough, low-dose vaginal estrogen or another prescription helps many women. Natural oils and herbs have little evidence and some can irritate.

Key facts

• Vaginal dryness is part of the genitourinary syndrome of menopause (GSM), caused by lower estrogen. It can also cause burning, pain with sex and bladder symptoms.
• Moisturizers and lubricants are different. Moisturizers are used regularly to keep tissue moist. Lubricants are used during sex to reduce friction.
• Low-dose vaginal estrogen comes as a cream, a small tablet or insert, or a soft ring that stays in place for 3 months.
• The American Urological Association recommends offering vaginal estrogen to peri- and postmenopausal women with repeat urinary tract infections, unless there is a reason not to use it.
• For women with a history of breast cancer, ACOG says non-hormonal options come first, and vaginal estrogen can be considered with the oncologist if they do not work.

Step 1: What can I do at home for vaginal dryness?

Use a vaginal moisturizer. These are over-the-counter gels or inserts used every 2 to 3 days, not only before sex. They cling to the vaginal wall and hold water. For many women with mild symptoms, this is enough.

Use a lubricant for sex.

Some lubricants are very concentrated (high "osmolality") and can draw water out of tissue, which may cause irritation. A World Health Organization advisory suggests lubricants with an osmolality under 1,200 mOsm/kg. Plain, unscented products without glycerin are often easier on sensitive tissue.

Avoid irritants. Skip douches, scented soaps, wipes, bubble baths and "feminine" sprays. Wash the vulva with water or a mild, unscented cleanser. Choose cotton underwear.

Do natural remedies for vaginal dryness work?

Many people search for natural or holistic options. Here is what the evidence shows:

• Non-hormonal moisturizers and lubricants are the main evidence-based choices without a prescription.
• Coconut oil, olive oil and vitamin E oil may feel soothing, but they have little research behind them and can damage latex condoms.
• Herbal supplements and soy have not been shown to reliably treat vaginal dryness.

If a remedy causes burning, itching or discharge, stop it and get checked.

Step 2: Prescription options when home care isn't enough

Low-dose vaginal estrogen treats the tissue directly. It comes as:

• a cream, applied with an applicator or fingertip, usually daily at first and then 2 to 3 times a week;
• a small tablet or soft insert, placed in the vagina, usually daily for 2 weeks and then twice a week;
• a soft ring, placed in the vagina and changed every 3 months.

Very little estrogen reaches the bloodstream at these doses, and a progestogen usually is not needed. Many women feel better within a few weeks, though full benefit can take 2 to 3 months. Treatment works only while you use it.

Other prescription options:

• Vaginal DHEA (prasterone): a nightly vaginal insert that the body turns into small amounts of hormones within the vaginal tissue.
• Ospemifene: a daily pill that acts like estrogen on vaginal tissue. It is FDA-approved for painful sex due to menopause. Its label has a boxed warning about endometrial cancer and stroke or blood clots, so it is not for everyone.
• Systemic hormone therapy: if you also have hot flashes, a pill, patch or gel may help both, though some women still need vaginal treatment too.

Step 3: Extra help for painful sex

• Pelvic floor physical therapy can help if the muscles have tightened up because of pain.
• Vaginal dilators, smooth graduated tubes, can gently stretch tissue, often with a physical therapist's guidance.
• Talking with your partner about pace, positions and more time for arousal can make a big difference.

What about vaginal dryness and UTIs?

Low estrogen changes the vaginal environment, which can make urinary tract infections more likely. For women around and after menopause who have repeat UTIs, the American Urological Association recommends vaginal estrogen to lower future risk, unless there is a reason not to use it.

What if I've had breast cancer?

ACOG advises starting with non-hormonal moisturizers and lubricants. If those do not help enough, vaginal estrogen may be considered after a careful talk about risks and in coordination with your oncologist. Extra care is needed if you take an aromatase inhibitor.

Does vaginal laser work?

Laser and other energy-based "vaginal rejuvenation" treatments have been promoted for dryness, but The Menopause Society says there is not yet enough good evidence to recommend them. In 2018 FDA warned that their safety and effectiveness for these uses has not been established, and reported harms include burns, scarring and pain.

What to ask your clinician

• Are my symptoms from menopause, or could it be an infection or skin condition?
• Which moisturizer and lubricant would suit me?
• Would vaginal estrogen help, and which form fits my routine?
• Is vaginal estrogen safe with my health history?
• Could treatment lower my chance of repeat UTIs?
• Would pelvic floor physical therapy help my pain?

FAQs

Which over-the-counter product should I try first? There is no single right product. A regular vaginal moisturizer plus a water- or silicone-based lubricant for sex works for many women with mild symptoms.

How long can I use vaginal estrogen? Many women use it long-term because symptoms return when it stops. Your clinician will review it with you each year. Report any vaginal bleeding.

Can I use coconut oil for vaginal dryness? Some women do, but evidence is limited, and oils can weaken latex condoms. If you notice itching or discharge, stop and get checked.

Is vaginal dryness a sign of something serious? Usually it is from lower estrogen. But bleeding after menopause, sores, lumps or a new discharge should always be checked.

Do I need a pelvic exam? Often, yes. An exam helps rule out infections and skin conditions that look like dryness.

Talk it through with Dr. Vargas

Vaginal dryness is a routine topic for an OB/GYN. Dr. Vargas can help you find the right mix of home care and treatment for your symptoms and health history.

Book a visit or call (210) 903-1030 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. About Dr. Vargas

Sources

• The North American Menopause Society. The 2020 genitourinary syndrome of menopause position statement. Menopause 2020;27(9):976-992: https://pubmed.ncbi.nlm.nih.gov/32852449/ (checked 2026-11-10)
• American Urological Association, Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline (2025 amendment): https://www.auanet.org/guidelines/guidelines/recurrent-uti (checked 2026-11-10)
• ACOG Committee Opinion No. 659, The use of vaginal estrogen in women with a history of estrogen-dependent breast cancer (2016): https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/03/the-use-of-vaginal-estrogen-in-women-with-a-history-of-estrogen-dependent-breast-cancer (checked 2026-11-10)
• Osphena (ospemifene) prescribing information: https://www.drugs.com/pro/osphena.html (checked 2026-11-10)
• UNFPA, Safe lubricants for all (2022), summarizing the WHO lubricant advisory: https://rhsupplies.org/uploads/tx_rhscpublications/UNFPA_Safe_Lubricants_For_All__Web__2022.pdf (checked 2026-11-10)
• FDA safety communication, FDA warns against use of energy-based devices to perform vaginal "rejuvenation" or vaginal cosmetic procedures (2018): https://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm615013.htm (checked 2026-11-10)
• MedlinePlus, Vaginal dryness: https://medlineplus.gov/ency/article/000892.htm (checked 2026-11-10)

---

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