Vaginal dryness is a common condition that affects many women at different life stages. This article explores the causes and symptoms of vaginal dryness, while our companion article on treating and preventing vaginal dryness provides solutions for finding relief.

I.  The Science of Vaginal Moisture: Your Body's Natural Balance

Have you ever wondered how your body naturally maintains vaginal moisture? Understanding this delicate system helps explain why disruptions can occur and how to address them effectively.

The Moisture-Making Mechanism

Your vagina is lined with specialized epithelial cells that produce a clear fluid that keeps tissues lubricated. This isn't just simple water, it's a complex mixture containing electrolytes, proteins, fatty acids, and other compounds that nourish tissues and support the vaginal ecosystem.

Several key mechanisms work together to maintain optimal moisture:

Transudate Production: The vaginal walls contain a rich network of blood vessels. When blood flow increases to this area, plasma seeps through the vaginal walls, creating a lubricating transudate. This process explains why arousal increases vaginal moisture, blood flow to the genital area intensifies during sexual excitement.

Mucus Secretion: Specialized cells in the vagina and cervix produce mucus that contributes to overall moisture. The consistency and amount of this mucus varies throughout your menstrual cycle, influenced by hormonal fluctuations.

Cellular Hydration: Vaginal cells contain molecules like hyaluronic acid that attract and hold water, helping tissues maintain their moisture content [1].

The Hormonal Orchestra

Hormones, particularly estrogen, play a starring role in vaginal moisture:

Estrogen Effects: This hormone increases blood flow to the vagina, enhances the production of transudate, stimulates mucus secretion, and maintains tissue thickness and elasticity. Estrogen also supports the production of glycogen, which feeds beneficial bacteria [5]. When hormone levels change, whether due to menopause, pregnancy, breastfeeding, or medications, these moisture-supporting mechanisms can be significantly affected.

The Microbiome Connection: Your Vaginal Ecosystem

Your vagina hosts a complex community of microorganisms, primarily beneficial Lactobacillus bacteria. This microbiome plays several crucial roles in supporting vaginal health, which contributes to optimal tissue function:

Lactic Acid Production: Lactobacilli convert glycogen (a sugar stored in vaginal cells) into lactic acid, creating the acidic environment (pH 3.8-4.5) where healthy vaginal tissues thrive.

Protective Barrier: The microbiome forms a living barrier that prevents harmful organisms from establishing themselves. When this barrier weakens, inflammation can occur, potentially affecting tissue health and comfort [8].

This explains why antibiotics, which can disrupt the vaginal microbiome, sometimes lead to vaginal dryness asa side effect.

Normal Variations vs. Concerning Changes

Vaginal moisture naturally fluctuates:

Menstrual Cycle Changes: Many women notice increased moisture during ovulation and decreased moisture just before or during menstruation. These changes occur due to fluctuations in estrogen levels throughout the menstrual cycle.

Age-Related Variations: Vaginal moisture typically peaks during reproductive years and gradually decreases with age due to declining estrogen levels, with more significant changes during perimenopause and menopause [13].

These normal variations differfrom persistent dryness that causes discomfort or affects quality of life.

Bottom Line: Vaginal moisture depends on a complex interplay between specialized cells that produce lubricating fluids, hormones (particularly estrogen) that support tissue health and secretions, and the vaginal microbiome that maintains the optimal environment for moisture production. This integrated system explains why multiple factors, from hormonal changes to microbiome disruptions, can affect vaginal comfort.

II.     Beyond Discomfort: Why Vaginal Dryness Matters

Vaginal dryness might seem like a minor inconvenience, but its impacts can extend far beyond momentary discomfort.

Physical Impacts: More Than Just Discomfort

Altered Microbiome: Vaginal dryness often coincides with changes in the vaginal microbiome, particularly a reduction in beneficial Lactobacillus species. This relationship is closely connected to estrogen levels: lower estrogen leads to increased dryness and epithelial thinning, which reduces Lactobacillus levels and creates greater tissue vulnerability to pathogens [14, 16]. This shift can create a cycle where decreased moisture leads to microbiome disruption, which further compromises moisture production and tissue health.

Increased Friction: Dry vaginal tissues experience more friction during activities like walking, exercising, or sexual intimacy. Over time, this increased friction can lead to irritation, inflammation, and potentially more significant tissue changes if left unaddressed.

Emotional and Relationship Impacts: The Hidden Effects

Intimacy Challenges: Painful intercourse (dyspareunia) resulting from vaginal dryness can significantly impact sexual satisfaction and intimacy [18], which can create distance in relationships.

Confidence and Self-Image: Persistent vaginal discomfort can affect how you feel about your body and your sense of femininity. Some women report feeling "older than their years" or that their body is "betraying them" when experiencing vaginal dryness.

Emotional Isolation: Because vaginal health is rarely discussed openly, many women report feeling isolated in their experience or uncertain about available treatment options [19].

Connection to Overall Vaginal Ecosystem Health

Early Warning System: Sometimes, vaginal dryness is one of the first noticeable signs of hormonal changes, microbiome disruption, or other health issues. Paying attention to this signal can help you address underlying causes before additional symptoms develop.

Predictor of Future Challenges: Untreated vaginal dryness can sometimes progress to more significant vaginal and urinary health issues. For example, chronic dryness in postmenopausal women may eventually lead to Genitourinary Syndrome of Menopause (GSM) [21], which can include urinary symptoms alongside vaginal discomfort.

‍

Bottom Line: Vaginal dryness impacts far more than momentary comfort. Physically, it can compromise tissue integrity, alter the protective microbiome, and increase friction- related irritation. Emotionally, it may affect intimate relationships, self-confidence, and overall quality of life. As an indicator of vaginal ecosystem health, dryness can serve as an early warning sign of hormonal changes, microbiome disruption, or other health issues that benefit from timely attention.

III. Common Causes: Why Am I Experiencing Vaginal Dryness?

Have you been wondering why you're experiencing vaginal dryness? Understanding these causes helps identify the most effective solutions for your specific situation.

Hormonal Factors: The Primary Influence

Menopause and Perimenopause: As estrogen levels decline during this transition, vaginal tissues often become thinner, less elastic, and produce less natural lubrication. This change affects up to 80% of postmenopausal women to some degree [13].

Postpartum and Breastfeeding: After childbirth, especially while breastfeeding, estrogen levels drop significantly. During breastfeeding, elevated prolactin levels suppress estrogen production, creating this temporary hormonal state that can cause vaginal dryness. This typically resolves once regular menstrual cycles return or breastfeeding ends.

Hormonal Contraceptives: Some birth control pills, patches, rings, and hormonal IUDs can reduce vaginal moisture in certain women.

Surgical Menopause: Women who have had their ovaries removed experience an immediate drop in estrogen, often resulting in more sudden and severe vaginal dryness than natural menopause.

Hormonal Cancer Treatments: Treatments for breast and other hormone-sensitive cancers often reduce estrogen levels, leading to vaginal dryness as a side effect.

Medication-Related Causes: Beyond Hormonal Treatments

Several common medications can contribute to vaginal dryness:

Antihistamines: These allergy medications work by drying up secretions, not just in your nose and eyes, but potentially throughout your body, including vaginal tissues [29].

Certain Antidepressants: Some antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can reduce vaginal lubrication as a side effect [26].

Blood Pressure Medications: Some antihypertensives can decrease blood flow to the vaginal area or affect secretions [28].

*If you suspect a medication might be contributing to your vaginal dryness, consult your healthcare provider before making any changes to your treatment regimen.

Lifestyle and Environmental Factors: Daily Influences

Insufficient Hydration: While drinking water doesn't directly increase vaginal moisture, chronic dehydration can affect mucous membranes throughout your body.

Irritating Products: Soaps, douches, feminine sprays, and even some laundry detergents can disrupt the vaginal environment through pH changes and tissue irritation, potentially contributing to discomfort and dryness.

Stress and Anxiety: Chronic stress affects hormone levels and can reduce blood flow to the genital area, potentially contributing to vaginal dryness. Specifically, elevated cortisol from chronic stress can inhibit estrogen-associated vaginal epithelial maturation[30] and reduce glycogen accumulation, which consequently affects the beneficial Lactobacillus population that helps maintain vaginal health.

Smoking: Cigarette smoking has anti-estrogenic effects and reduces blood flow throughout the body, including to vaginal tissues. Additionally, smoking can negatively impact the vaginal microbiota, further affecting vaginal health [31].

Health Conditions: When Underlying Issues Play a Role

Sjögren's Syndrome: This autoimmune disorder affects moisture-producing glands [33] throughout the body, including those in the vaginal area.

Diabetes: Poorly controlled diabetes can affect blood flow and nerve function [34], potentially leading to reduced vaginal lubrication.

Thyroid Disorders: Both hypothyroidism and hyperthyroidism can disrupt hormone balance [35] and affect vaginal health.

The Multifactorial Reality: When Causes Combine

For many women, vaginal dryness results from a combination of factors rather than a single cause. This multifactorial nature explains why the most effective approaches often address several potential causes simultaneously.

Bottom Line: Vaginal dryness typically stems from one or more of four main categories of causes: hormonal factors (including menopause, postpartum states, and hormonal medications), non-hormonal medications (such as antihistamines and certain antidepressants), lifestyle and environmental influences (including insufficient hydration, irritating products, and stress), and underlying health conditions (like Sjögren's syndrome and diabetes). For many women, multiple factors contribute simultaneously, which is why comprehensive approaches often provide the most effective relief.

IV. Recognizing the Signs: Symptoms and Self- Assessment

How do you know if what you're experiencing is vaginal dryness? While the name suggests a simple lack of moisture, the symptoms can actually manifest in various ways.

Common Symptoms: Beyond Just "Dryness"

Sensation of Dryness or Tightness: The most obvious symptom is a feeling of dryness or lack of moisture in the vaginal area. Some women describe it as a "tight" or "rough" sensation that wasn't previously present.

Discomfort or Irritation: Many women experience general discomfort, itching, burning, or irritation in the vaginal and vulvar areas, even when not engaged in physical activity.

Pain During Intercourse: Medically termed "dyspareunia," pain during sexual activity is one ofthe most common symptoms that prompts women to seek help for vaginal dryness [18].

Light Bleeding After Intercourse: When vaginal tissues become thin and fragile due to dryness, they may develop small tears during intercourse, leading to light spotting afterward.

Decreased Natural Lubrication During Arousal: You may notice that it takes longer to become lubricated during sexual arousal, or that natural lubrication is insufficient for comfortable intimacy.

How Symptoms Vary Across Life Stages

Reproductive Years: During reproductive years, vaginal dryness often occurs primarily during sexual activity, with few symptoms at other times. It may be cyclical, worsening at certain points in your menstrual cycle.

Perimenopause: As estrogen levels begin to fluctuate, you might notice intermittent dryness that comes and goes, sometimes accompanied by other perimenopausal symptoms like irregular periods or hot flashes.

Postmenopause: After menopause, symptoms tend to be more persistent and may affect daily comfort, not just sexual activity. Without treatment, symptoms often progressively worsen overtime.

Postpartum Period: Dryness during the postpartum period, especially while breastfeeding, may be accompanied by other symptoms like vaginal tenderness from childbirth recovery.

Distinguishing from Other Vaginal Conditions

Several conditions can cause symptoms similar to vaginal dryness. Understanding the differences helps ensure appropriate care:

Yeast Infections: Unlike vaginal dryness, yeast infections typically cause thick, white, cottage cheese-like discharge [36] along with intense itching.

Bacterial Vaginosis (BV): BV usually presents with increased discharge with a distinctive fishy odor [37], particularly after intercourse, rather than the decreased discharge typical of vaginal dryness.

Contact Dermatitis: Allergic reactions to products like soaps or laundry detergents typically cause more localized irritation and may include visible rash or redness, unlike the more generalized discomfort of vaginal dryness.

Self-Assessment: Questions to Consider

To help determine if you're experiencing vaginal dryness, ask yourself:

• Do I feel dryness, tightness, or irritation in my vaginal area?

• Is intercourse uncomfortable or painful?

• Have I noticed decreased lubrication during arousal?

• Do I experience itching or burning without signs of infection?

If you answer yes to one or more of these questions, vaginal dryness may be a contributing factor.

BottomLine: Vaginal dryness symptoms can include dryness, tightness, irritation, itching, burning, pain during intercourse, and light bleeding after intercourse. Symptoms often vary depending on life stage. It's important to distinguish these symptoms from those of infections like yeast infections or BV. Self-assessment can help identify potential vaginal dryness, but professional diagnosis is recommended for confirmation and appropriate care.

V. Top 5 Treatments for Vaginal Dryness

Now that you understand the causes and symptoms of vaginal dryness, here's a quick overview of the most effective treatment options:

Vaginal Moisturizers: Regular use of moisturizers containing hyaluronic acid [38] helps maintain ongoing hydration between applications.

Lubricants for Sexual Activity: Water-based or silicone-based lubricants reduce friction and discomfort during intimacy.

Low-Dose Vaginal Estrogen: Prescription estrogen products delivered directly to vaginal tissues [39] with minimal systemic absorption.

Vitamin E Suppositories: Studies show these can improve tissue health [40] and relieve symptoms, especially for those who prefer non-hormonal options.

Pelvic Floor Exercises: Regular exercises increase blood flow to the vaginal area [41], potentially improving natural lubrication.

For detailed information about these treatments and prevention strategies, see our comprehensive article on treating and preventing vaginal dryness.

VI. Frequently Asked Questions

Q1: Is vaginal dryness only aproblem for menopausal women?

No. While it's most common during and after menopause due to declining estrogen, vaginal dryness can affect women at any age. Causes in younger women can include breastfeeding, certain medications (like hormonal contraceptives or antihistamines), stress, or underlying health conditions.

Q2: Can vaginal dryness cause itching?

Yes, itching is a common symptom of vaginal dryness. The lack of moisture can lead to irritation and an itching or burning sensation in the vaginal and vulvar areas.

Q3: Will vaginal dryness go away on its own?

It depends on the cause. Dryness related to temporary factors like breastfeeding often resolves once the underlying cause changes. However, dryness related to menopause typically persists or worsens without treatment because the underlying estrogen deficiency doesn't resolve on its own.

Q4: Can stress cause vaginal dryness?

Chronic stress can potentially contribute to vaginal dryness. Stress affects hormone levels and can reduce blood flow to the genital area. Managing stress through techniques like mindfulness, yoga, or exercise may help support overall vaginal health.

Q5: What is the connection between vaginal dryness and sexual discomfort?

Vaginal dryness is a leading cause of painful intercourse (dyspareunia) in women. Without adequate lubrication, friction increases during sexual activity, which can cause pain, micro-tears in vaginal tissues, and even light bleeding. This discomfort often leads to decreased sexual desire and satisfaction, creating a cycle that can impact intimate relationships. Using appropriate lubricants during sexual activity and addressing underlying causes of dryness can help restore comfortable and enjoyable intimacy.

Understanding the causes and symptoms of vaginal dryness is the first step toward addressing this common condition. For information about treatment options and prevention strategies, see our companion article on treating and preventing vaginal dryness.

References

1. National Institute of Health. (2023). Female Reproductive System. StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK545147/

2. Traish, A., et al. (2022). Biochemical Factors Modulating Female Genital Sexual Arousal Physiology. International Society for Sexual Medicine. DOI: https://doi.org/10.1016/j.jsxm.2022.01.516

3. Adnane, S., et al. (2018). Cervico-vaginal mucus (CVM) – an accessible source of immunologically informative biomolecules. Frontiers in Immunology, 9, 1534. DOI: https://doi.org/10.3389/fimmu.2018.01534

4. Munarriz, R., et al. (2002). Biology of female sexual function. Urologic Clinics of North America, 29(3), 685-693. DOI: https://doi.org/10.1016/S0094-0143(02)00069-1

5. Krychman, M. L. (2011). Vaginal estrogens for the treatment of dyspareunia. Journal of Sexual Medicine, 8(3), 666-674. DOI: https://doi.org/10.1111/j.1743-6109.2010.02181.x

6. Mayo Clinic Health System. (2024). Vaginal dryness: Symptoms, causes, and remedies. Available at: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/vaginal-dryness-symptoms-causes-and-remedies

7. National Institute of Health. (2023). Menstrual Cycle. Available at: https://www.ncbi.nlm.nih.gov/books/NBK279054/

8. Smith, S. B., & Ravel, J. (2016). The vaginal microbiota, host defence and reproductive physiology. Journal of Physiology, 595(2), 451-463. DOI: https://doi.org/10.1113/JP271694

9. Chee, W. J. Y., et al. (2020). Vaginal microbiota and the potential of Lactobacillus derivatives in maintaining vaginal health. Microbial Cell Factories, 19(1), 203. DOI: https://doi.org/10.1186/s12934-020-01464-4

10. Mendling, W. (2016). Vaginal Microbiota. Advances in Experimental Medicine and Biology, 902, 83-93. DOI: https://doi.org/10.1007/978-3-319-31248-4_6

11. Najmabadi, S., et al. (2021). Cervical mucus patterns and the fertile window in women without known subfertility: a pooled analysis of three cohorts. Human Reproduction, 36(7), 1784-1795. DOI: https://doi.org/10.1093/humrep/deab049
‍

12. Eschenbach, D. A., et al. (2000). Influence of the Normal Menstrual Cycle on Vaginal Tissue, Discharge, and Microflora. Clinical Infectious Diseases, 30(6), 901-907. DOI: https://doi.org/10.1086/313818

13. Cagnacci, A., et al. (2019). Female sexuality and vaginal health across the menopausal age. Menopause, 26(4), 364-370. DOI: https://doi.org/10.1097/GME.0000000000001241

14. Hummelen, R., et al. (2011). Vaginal Microbiome and Epithelial Gene Array in Post-Menopausal Women with Moderate to Severe Dryness. PLoS One, 6(11), e26602. DOI: https://doi.org/10.1371/journal.pone.0026602

15. Oliveira, L., et al. (2022). Postmenopausal Vaginal Microbiome and Microbiota. Frontiers in Reproductive Health, 4, 780931. DOI: https://doi.org/10.3389/frph.2022.780931

16. Muhleisen, A. L., & Herbst-Kralovetz, M. M. (2016). Menopause and the vaginal microbiome. Maturitas, 91, 42-50. DOI: https://doi.org/10.1016/j.maturitas.2016.05.015
‍

17. Nieto, A., et al. (2025). Menopausal shift on women's health and microbial niches. npj Women's Health, 3, 15. DOI: https://doi.org/10.1038/s44294-024-00050-y

18. Graziottin, A. (2015). Vaginal biological and sexual health – the unmet needs. Climacteric, 18(4), 536-545. DOI: https://doi.org/10.3109/13697137.2015.1079408

19. Women's Health Concern.(2023). Vaginal Dryness Fact Sheet. Available at: https://www.womens-health-concern.org/wp-content/uploads/2023/11/25-WHC-FACTSHEET-VaginalDryness-OCT2023-B.pdf

20. Parish, S. J., et al. (2013). Impact of vulvovaginal health on postmenopausal women: a review of surveys on symptoms of vulvovaginal atrophy. International Journal of Women's Health, 5, 437-447. DOI: https://doi.org/10.2147/IJWH.S44579

21. National Institute ofHealth. (2023). Genitourinary Syndrome of Menopause. Available at: https://www.ncbi.nlm.nih.gov/books/NBK559297/

22. Angelou, K., et al. (2022). The Genitourinary Syndrome of Menopause: An Overview of the Recent Data. Cureus, 14(4), e24505. DOI: https://doi.org/10.7759/cureus.7586

23. Waetjen, L. E., et al. (2018). Factors associated with developing vaginal dryness symptoms in women transitioning through menopause: a longitudinal study. Menopause, 25(10), 1094-1104. DOI: https://doi.org/10.1097/gme.0000000000001130

24. Perelmuter, J. B., et al. (2025). Postpartum and Lactation-Related Genitourinary Symptoms. Obstetrics & Gynecology, 145(1), 45-52. DOI: https://doi.org/10.1097/aog.0000000000005940

25. Falk, S. J., & Dizon, D. S. (2016). Vaginal Health During Breast Cancer Treatment. Current Treatment Options in Oncology, 17(3), 12. DOI: https://doi.org/10.1007/s11912-016-0517-x

26. Lorenz, T., et al. (2016). Antidepressant-Induced Female Sexual Dysfunction. Mayo Clinic Proceedings, 91(9), 1280-1286. DOI: https://doi.org/10.1016/j.mayocp.2016.04.033

27. Reisman, Y. (2017). Sexual Consequences of Post-SSRI Syndrome. Sexual Medicine Reviews, 5(4), 429-433. DOI: https://doi.org/10.1016/j.sxmr.2017.05.002

28. Lou, J. S., et al. (2023). Relationship Between Hypertension, Antihypertensive Drugs and Sexual Dysfunction in Men and Women: A Literature Review. Current Hypertension Reports, 25(4), 75-89. DOI: https://doi.org/10.2147/VHRM.S439334

29. National Institute ofHealth. (2023). Dehydration and Body Water. Available at: https://www.ncbi.nlm.nih.gov/books/NBK555956/

30. Amabebe, E., & Anumba, D. O. C. (2018). Psychosocial Stress, Cortisol Levels, and Maintenance of Vaginal Health. Frontiers in Endocrinology, 9, 568. DOI: https://doi.org/10.3389/fendo.2018.00568

31. Brodman, M., et al. (2014). Association between cigarette smoking and the vaginal microbiota: a pilot study. Journal of Lower Genital Tract Disease, 18(2), 129-134. DOI: https://doi.org/10.1186/1471-2334-14-471

32. Tankó, L. B., & Christiansen, C. (2004). An update on the antiestrogenic effect of smoking: a literature review with implications for researchers and practitioners. Menopause, 11(1), 104-109. DOI: https://doi.org/10.1097/01.GME.0000079740.18541.DB

33. Farenhorst, M., et al. (2021). Clinical determinants of vaginal dryness in patients with primary Sjögren's syndrome. RMD Open, 7(2), e001643. DOI: https://doi.org/10.55563/clinexprheumatol/hzveng

34. Winkley, K., et al. (2021). Sexual health and function in women with diabetes. Diabetic Medicine, 38(2), e14415. DOI: https://doi.org/10.1111/dme.14644

35. Salari, N., et al. (2024). The sexual dysfunction in women with thyroid disorders: a meta-analysis. BMC Women's Health, 24, 45. DOI: https://doi.org/10.1186/s12902-024-01817-9

36. National Institute ofHealth. (2023). Vulvovaginal Candidiasis. Available at: https://www.ncbi.nlm.nih.gov/books/NBK459317/

37. National Institute ofHealth. (2023). Bacterial Vaginosis. Available at: https://www.ncbi.nlm.nih.gov/books/NBK459216/

38. Potter, N., & Panay, N. (2020). Vaginal lubricants and moisturizers: a review into use, efficacy, and safety. Climacteric, 23(1), 13-24. DOI: https://doi.org/10.1080/13697137.2020.1820478

39. Rahn, D. D., et al. (2014). Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstetrics & Gynecology, 124(6), 1147-1156. DOI: https://doi.org/10.1097/AOG.0000000000000526

40. Rad, M., et al. (2016). A survey of the therapeutic effects of Vitamin E suppositories on vaginal atrophy in postmenopausal women. International Journal of Gynecology & Obstetrics, 135(1), 52-56. DOI: https://doi.org/10.4103/1735-9066.193393

41. Mercier, J., et al. (2016). Pelvic floor muscles training to reduce symptoms and signs of vulvovaginal atrophy: a case study. Case Reports in Women's Health, 12, 7-12. DOI: https://doi.org/10.1097/gme.0000000000000620

‍