Vaginal and vulvar dryness after menopause

Vaginal and vulvar dryness after menopause is one of the most common things that happens to a woman's body, and it is not a personal failing. It is driven by the drop in estrogen, which changes the tissue itself. Some of what helps you can buy tonight without asking anyone, and some of it you need a doctor for. We will be plain about which is which. We are not doctors, and this page does not stand in for one.

Hot flashes get talked about and this does not

Women come into this shop and describe two years of avoiding their husband before anyone said the word dryness out loud to them, their own doctor included.

Your doctor may not raise it, and appointments are short. So raise it yourself, early in the appointment rather than with your hand on the door. Two sentences do it. Sex has become painful and I think I am dry. What are my options, including prescription ones?

You do not owe anyone an explanation of your marriage.

Estrogen is what changed

Estrogen drops at menopause, and the tissue of the vulva and vagina responds to estrogen. With less of it, that tissue tends to get thinner and less elastic, and it makes less of its own lubrication. What that feels like is friction where there never used to be any, and a sting that can last into the next day.

The same thing happens in perimenopause, which can run for years before your last period. Low estrogen while breastfeeding does it too, which blindsides women in their thirties who assumed this was a much later problem. Some medications bring it on as well, including some cancer treatments.

Clinicians generally describe the menopausal version as ongoing rather than temporary. It is not a phase you wait out, which is worth asking about at an appointment rather than waiting to see whether next year is any different. The breastfeeding version is not the same, and that one often settles after you wean and estrogen comes back up.

This is physiology, not a message about your relationship. Wanting someone and being wet run on different systems, and after menopause the second one often stops keeping up with the first.

Outside, inside, and in the moment

Two different products do two different jobs here. A moisturizer goes on a schedule whether or not sex happens, and a lubricant goes on at the time, for friction. The long version of that, including which lubricant goes with condoms, is in moisturizer or lubricant, and when you need both.

Foria's Everyday Vulva Moisturizer is the external one. It is a hormone-free pump bottle, 1.7 fl oz, made with organic botanicals for vulvar skin. Work it in with clean fingers at whatever time of day you will remember.

Foria's Hydrating Melts are the internal one. They are individually wrapped suppositories that hydrate internal tissue with organic botanicals, and the timing to follow is the timing on the carton.

We carry three lubricants and all three are water-based. Wicked's Aloe Lubricant is the plain 4 fl oz bottle for ordinary days, and it says safe with silicone toys on the label. Wicked's Simply Natural Gel is the one that is latex condom compatible. System JO's Agape is made without parabens, glycerin or glycol, and without oil or silicone, and it is what women who have reacted to a lubricant before come in asking for. Agape does not carry the silicone toy line the two Wicked bottles carry, so we do not claim it for them.

The part that costs us the sale is this. These are comfort and care products, and none of them is a treatment for menopause or a way of making dryness go away. A shop that tells you otherwise is selling you out of a doctor's office. They can make tonight easier.

There are prescription options and we do not sell them

There is a whole category of prescription treatment for this. Vaginal estrogen at a low dose is the one most women have heard of, and there are options that are not estrogen at all. We do not stock any of it, and nothing on our shelves stands in for it. We are not in a position to recommend it or to rule it out either, and that is precisely why it is an appointment and not a purchase.

Whether any of it suits you depends on your history. If breast cancer is part of that history, that makes it more of a conversation with a doctor rather than less, and not one to settle off a website, this one included.

The clinical name for all of this is genitourinary syndrome of menopause. Knowing the phrase helps in a room where you feel rushed, and it is a better thing to type into a search box than dryness.

Call a doctor about these

Make the appointment now.

• Pain during sex. Not less comfortable than it used to be, but pain.
• Any bleeding after menopause, including spotting and including a smear after sex. Do not wait that one out.
• Dryness that is new and that you cannot account for.
• Anything that changed suddenly rather than slowly.
• Burning or itching that will not let up, or skin that cracks or splits.
• A change in the skin of the vulva you can see or feel. A lump, a sore, or a patch that looks different from the skin around it.
• Discharge that is new to you, or that has an odor.
• Urinary symptoms that keep coming back.
• Dryness that started around a new medication. Do not stop taking anything on your own. Tell whoever prescribed it.

We are not listing those to frighten you, and we are not going to tell you what any of them means, because we cannot know that and neither can a website. They are questions for someone who can examine you. Put the ones that apply to you in your phone before you go in, because that list is the appointment.

If the first doctor waves it off as part of getting older, you are entitled to ask for a second opinion, and this is a reasonable thing to ask for one about.

The bottle tonight, the appointment this week

Buy the thing that makes tonight easier if you want it. Then book the appointment, while this tab is still open and you are still annoyed enough to.