- Low oestrogen thins the vaginal tissues, leading to dryness, irritation, and painful intercourse.
- This is a medical condition known as Genitourinary Syndrome of Menopause (GSM).
- Local vaginal oestrogen is a highly effective and safe treatment.
- Non-hormonal moisturisers and lubricants also provide significant relief.
Why Does Menopause Cause Vaginal Dryness?
After menopause, the drop in oestrogen levels causes the tissues of the vagina and vulva to become thinner, less elastic, and drier. This condition is called Genitourinary Syndrome of Menopause (GSM). It can lead to feelings of soreness, itching, and burning, and make penetrative sex uncomfortable or painful.
Many women I speak to from the UK are embarrassed to bring this up, but it is a direct and treatable consequence of hormonal changes. It affects over half of post-menopausal women, so please know you are not alone and there is no need to simply put up with it.
Local Oestrogen: A Targeted Solution
The most effective way to treat GSM is to reintroduce a small amount of oestrogen directly to the affected area. This is known as local or vaginal oestrogen. It's available as a small pessary, a cream, or a vaginal ring.
This is not the same as systemic HRT. The dose is very low and it works directly on the vaginal tissues to restore moisture and elasticity, with minimal absorption into the rest of the body. You can get it on prescription from your GP or an NHS menopause clinic.
Moisturisers and Lubricants
Alongside local oestrogen, or for women who prefer a non-hormonal route, there are excellent options. Vaginal moisturisers are designed for regular use to hydrate the tissues and improve comfort day-to-day. They work by drawing water into the tissue.
Vaginal lubricants are different; they are used at the time of intimacy to reduce friction. Using a good quality, pH-balanced lubricant can make an immediate difference to comfort during sex. There are many brands available over the counter.
Frequently asked questions
Is vaginal oestrogen the same as body HRT?
No. Systemic HRT (tablets, patches, gels) circulates throughout your whole body. Local oestrogen works only in the specific area it is applied and is absorbed into the bloodstream in tiny amounts. It's very safe and can even be used by many women who cannot take systemic HRT.
Are lubricants and vaginal moisturisers the same?
They have different jobs. Lubricants are used just before or during sex to reduce friction and make it more comfortable. Vaginal moisturisers are for regular use, two to three times a week, to hydrate the tissues and provide lasting relief from day-to-day dryness.
How long will I need to use treatment for?
Genitourinary Syndrome of Menopause is a chronic condition, meaning it won't go away on its own. You will likely need to use these treatments long-term to keep the symptoms at bay. The good news is that they are safe for long-term use.
Can these symptoms be reversed?
While you can't reverse the underlying hormonal changes, you can very effectively manage and relieve the symptoms. Consistent use of local oestrogen, moisturisers, and lubricants can restore comfort, moisture, and elasticity to the vaginal tissues.
Could a doctor-led plan help you?
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