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Symptoms

Vaginal & Vulvar Dryness

Dryness is one of the most common changes during perimenopause and menopause—and one of the most undertreated. Understanding why it happens can change how you respond.

What's Actually Happening

The tissues of the vulva and vagina are among the most hormonally responsive in the body. When estrogen levels shift—whether during perimenopause, menopause, postpartum, or periods of high stress—these tissues can become thinner, less elastic, and produce less natural lubrication.

This isn't a failure of your body. It's communication.

The vulva and vagina respond instantly to changes in hormones, microbiome, stress chemistry, circulation, and even emotional climate. When dryness appears, your body is adapting to a new internal environment.

Research shows that approximately two-thirds of women in perimenopause, menopause, or post-menopause experience vulvar skincare needs including dryness. Yet this remains one of the least discussed aspects of women's health—and one of the most undertreated.

Why It Occurs

Hormonal transitions are the most common trigger:
  • Perimenopause and menopause: Declining estrogen levels naturally thin the vaginal lining and shift its microbiome
  • Postpartum and breastfeeding: Estrogen dips significantly during this time, particularly while nursing
  • Hormonal birth control: Some formulations can reduce natural lubrication
Stress and nervous system activation:

When your body is in energy-saving mode or running on stress chemistry, it deprioritizes reproductive tissue maintenance. High cortisol can reduce blood flow to the vulva and vagina, affecting natural moisture.

External factors:
  • Scented soaps, bubble baths, and douches can strip away natural oils and upset pH balance
  • Certain medications, including antihistamines and some antidepressants
  • Dehydration and nutritional deficiencies

What Your Body May Be Telling You

Christine writes extensively about the vulva as a "finely tuned sensor" of overall wellbeing. Dryness rarely appears in isolation—it often accompanies or signals:

  • Hormone shifts that may benefit from support
  • Stress levels that need attention
  • Nutritional needs that aren't being met
  • Emotional states that are asking to be witnessed

Rather than approaching dryness as a problem to eliminate, consider it an invitation to listen more closely to what your body needs.

Approaches That Help

Topical moisture and nourishment

The vulvar skin benefits from regular, gentle moisture—not just during intimacy, but as daily care. Look for products formulated specifically for this sensitive tissue, free from fragrances and irritating ingredients.

Addressing the root causes

  • Hormone support: For many women, topical estrogen or systemic HRT can restore tissue health. This is a conversation to have with your healthcare provider.
  • Stress regulation: Practices that calm the nervous system can improve blood flow and tissue health over time.
  • Nutrition: Omega-3 fatty acids, adequate hydration, and phytoestrogens (from foods like flax and soy) support tissue moisture.

During intimacy

  • Use lubricants designed for sensitive tissue
  • Allow more time for arousal—responsive desire is normal, especially during hormonal transitions
  • Communicate with your partner about what feels good and what doesn't

The Connection to UTIs

One overlooked cause of frequent UTIs is vaginal dryness. When the vaginal and vulvar tissues become thinner and less lubricated, the protective barrier against bacteria weakens. The tissue is more susceptible to micro-tears, and the pH environment can shift in ways that allow harmful bacteria to flourish.

If you're experiencing recurrent UTIs, addressing underlying dryness may be an important part of the solution.


Go Deeper

These are the original writings this entry draws from:


Explore more

Continue through our menopause collection, and keep reading:

What can help: For everyday comfort through the transition, many women reach for Honor, our daily vaginal moisturizer, with Soothe for on-the-spot calm.

Frequently asked

Why does vaginal dryness happen?
The vulvar and vaginal tissues are very responsive to estrogen, so when levels shift during perimenopause, menopause, postpartum, or breastfeeding, the tissue can become thinner and produce less natural lubrication. Certain medications, harsh soaps, and stress can add to it.
Is vaginal dryness common?
Very. Depending on the study, up to roughly half or more of postmenopausal women experience vaginal dryness or genitourinary syndrome of menopause. It's common, and it's also very treatable.
What actually helps with dryness?
Non-hormonal moisturizers and lubricants formulated for sensitive tissue are a good first step, and local vaginal estrogen is often considered the gold standard when appropriate. A provider can help you choose based on your health history.
Can vaginal dryness cause urinary tract infections?
It can contribute. As tissue thins and the vaginal environment shifts, the barrier against bacteria weakens, and studies show vaginal estrogen can lower the risk of recurrent UTIs in postmenopausal women. If you get frequent UTIs, it's worth raising with your provider.

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References

  1. Vaginal Dryness: Causes, Symptoms & Treatment— Cleveland Clinic
  2. Genitourinary Syndrome of Menopause (MenoNote)— The Menopause Society
  3. The Genitourinary Syndrome of Menopause: An Overview of the Recent Data— National Library of Medicine (PMC)
  4. Use of Moisturizers and Lubricants for Vulvovaginal Atrophy— National Library of Medicine (PMC)
  5. Urinary Tract Infection in Postmenopausal Women— National Library of Medicine (PMC)
  6. Vaginal estrogen therapy is associated with decreased inflammatory response in postmenopausal women with recurrent urinary tract infections— National Library of Medicine (PMC)