Vaginal Dryness

Vaginal dryness reflects thinning and reduced lubrication of the vaginal tissue, usually driven by falling oestrogen - at menopause, during breastfeeding, after certain cancer treatments, or with medications such as aromatase inhibitors, some contraceptives and antihistamines. It is part of what is now called genitourinary syndrome of menopause, which also includes irritation, painful sex and urinary symptoms, and unlike hot flushes it tends to persist and progress rather than resolve with time. Non-hormonal management works well for many: vaginal moisturisers used regularly two to three times weekly to maintain tissue hydration, and separate lubricants for intercourse, with water or silicone-based products preferred and pH-balanced formulations better tolerated. Regular sexual activity or use of dilators helps maintain tissue elasticity. Low-dose vaginal oestrogen is highly effective, acts locally with minimal systemic absorption, and is appropriate for most women including many with a history of breast cancer after specialist discussion. Supplement evidence is limited and mostly indirect: vitamin E and hyaluronic acid used vaginally have small trials showing symptom improvement, sea buckthorn oil taken orally has one modest trial, and oral phytoestrogens have inconsistent results for vaginal symptoms specifically.