What Is Vaginal Dryness? Causes, Symptoms, and Treatment Options

Key Takeaways

• Vaginal dryness affects between 3% and 47% of women depending on age and hormonal status, and 17% of women experience it unrelated to menopause (Dennerstein et al., 2000; Currie, 2023).
• The most common causes are perimenopause and menopause, but breastfeeding, certain medications, and medical treatments can also contribute.
• Vaginal dryness can be mild to severe — symptoms include itching, burning, soreness, tightness, and pain during sex.
• First-line treatment includes vaginal moisturizers used daily and water-based lubricants used during intimacy. Ingredients like hyaluronic acid and vitamin E help draw and retain moisture.
• When dryness contributes to painful sex or pelvic floor tightening, a broader approach — including dilation therapy and intimacy support — can help address the full picture.

How do you treat vaginal dryness? Believe it or not, 1 in 8 women experience vaginal dryness. There are ways to recognize the symptoms and find relief. We turned to our friends at FemmePharma to help shed some light on this topic. Here is their guest article on vaginal dryness.

Experiencing discomfort related to vaginal dryness is fairly common depending on age and menopausal status, with a reported prevalence of 3 to 47% of women (Dennerstein et al., 2000).

What Causes Vaginal Dryness?

Vaginal dryness is most associated with perimenopause and menopause, but there may be other contributing causes (Portman & Gass, 2014):

• Endometriosis treatments
• Antihistamines
• After childbirth
• Breastfeeding
• Oral contraceptive use
• Antidepressant use (specifically SSRIs)
• Breast cancer treatment
• Sjögren’s Syndrome

Antihistamines have drying effects on mucous membranes throughout the body, including the vagina, and SSRIs and SNRIs can reduce vaginal lubrication through their effects on serotonin signaling and blood flow (TeleDirectMD, 2026). During breastfeeding, elevated prolactin levels suppress estrogen, creating a temporary hypoestrogenic state that frequently causes vaginal dryness and painful intercourse — typically resolving once nursing stops (TeleDirectMD, 2026).

For many women, vaginal dryness is accompanied by related conditions such as vaginal stenosis, vaginal atrophy, or vaginismus.

Vaginal stenosis is when the vaginal canal becomes narrower and shorter, possibly associated with dryness, thinning, and scar tissue. This condition may result from chemotherapy, surgery, pelvic radiation, or hormonal changes, and can cause pain during intercourse.

Vaginal atrophy occurs when a decrease in estrogen causes the vagina to become thinner, drier, and inflamed (Portman & Gass, 2014). Using a high-quality moisturizer daily may lead to overall improvement in vaginal health.

Vaginal Dryness During Sex

Some women experience vaginal dryness only before, during, or after intimacy. In fact, 17% of women experience vaginal dryness unrelated to menopause (Currie, 2023). Vaginal dryness during sex can cause intimacy to be painful and may lead to lower sexual desire.

There may be a simple answer for vaginal dryness during sex, like not enough foreplay. Foreplay is essential to help the vagina naturally lubricate itself for penetrative sex. There are small glands at the opening of the vagina called Bartholin and Skene glands that secrete fluid to help lubricate the vagina. Supplementing with a personal lubricant before penetrative sex will help to minimize dryness, discomfort, and friction.

Persistent pain during sex is called dyspareunia, and it affects approximately 10–20% of U.S. women (Faubion et al., 2021). If painful intercourse persists, please speak with your healthcare provider.

What Does Vaginal Dryness Feel Like?

Vaginal dryness may range from mild to severe. Mild dryness may be only an annoyance, but even moderate dryness can cause painful sex, a frequent urge to urinate, painful urination, and recurring urinary tract infections (Portman & Gass, 2014). Vaginal dryness may feel like:

• Itching
• Burning
• Soreness
• Tightness
• Vulvar irritation
• Pain around the vagina
• Pain inside the vagina

How to Treat Vaginal Dryness

Vaginal dryness is best treated with a vaginal moisturizer and personal lubricant. Vaginal moisturizers are intended to be used daily to help improve the vaginal tissue, elasticity, and pliability of the vagina. When applied, vaginal moisturizers adhere to the vaginal wall and to the mucosa, which promotes hydration and helps to stimulate lubrication.

When choosing a vaginal moisturizer and personal lubricant, be sure to look at the ingredients. Lubricants made with hyaluronic acid and vitamin E help draw moisture into the tissues and keep it there (Jokar et al., 2023). Always avoid flavored lubricants — they often contain glucose (sugar), which may increase your chances of developing yeast infections. For a full breakdown of lubricant types, what to look for, and what to avoid — including what is and is not compatible with silicone devices like Milli — see our guide How to Use Lube With Milli.

Mia Vita Personal Lubricant & Moisturizer is an FDA-cleared nonprescription relief from vaginal dryness. When used regularly, it can provide relief from vaginal burning, itching, and pain, and allow for more comfortable sex. Mia Vita Personal Lubricant & Moisturizer is a water-based lubricant that does not leak, drip, or cause a mess. With minimal volume, you receive maximum relief.

If you purchase Milli, you will also receive a 15% discount coupon for Mia Vita Personal Lubricant & Moisturizer — a natural complement to Milli for women managing dryness alongside their dilation therapy.

“Vaginal dryness during sex can cause intimacy to be painful and may lead to lower sexual desire. Supplementing with a personal lubricant before penetrative sex will help to minimize dryness, discomfort, and friction — but that is often just the first step.”

When Dryness Is Part of a Larger Picture: Dilation, Vibration, and Intimacy

For some women, vaginal dryness is one piece of a more complex picture. When dryness accompanies pelvic floor tightening, fear of penetration, or a condition like vaginismus, lubricant alone may not be sufficient to restore comfortable intimacy. In those cases, a broader approach — one that addresses both the tissue and the muscle response — is often more effective.

Dilation Therapy

The Milli Vaginal Dilator is an FDA-cleared medical device used to treat vaginismus and related painful sex (dyspareunia) (Nguyen & Duong, 2024). Per the Milli Instructions for Use, water-based lubricants — like Mia Vita Personal Lubricant and Moisturizer — can be used prior to insertion and are recommended for Milli’s silicone-coated surface. They are easy to wash off with mild soap and water after each session.

Consistency is a critical factor in how quickly dilation therapy produces results. In a recent clinical study of Milli users, 85% made measurable progress toward intercourse within 90 days. For more on how dilation therapy works and what the research shows, see our article Do Vaginal Dilators Work?.

Vibration for Muscle Relaxation

Milli also includes optional integrated vibration — a feature that many women find helps relax pelvic floor muscles during dilation sessions, making the experience feel less clinical and more manageable. In a recent clinical study of Milli users, 80% used vibration at least half the time, and 57% reported reduced anxiety related to sex after just 3 months (Materna Medical, Data on File). For more on how vibration supports pelvic floor relaxation during therapy, see our article on the potential benefits of vibration therapy.

Maintaining Intimacy While You Heal

When penetrative sex is painful or not currently possible, it can put significant strain on intimacy and connection. But sex is more than penetration — and many couples find that redefining intimacy during treatment actually strengthens their relationship. Foreplay, non-penetrative touch, and open communication about what feels comfortable are all part of a holistic approach to sexual health. Our articles on intimacy with vaginismus and painful sex and sexual desire explore how couples navigate this together.

FAQs

What causes vaginal dryness?

Vaginal dryness is most commonly associated with perimenopause and menopause, but it can also be caused by breastfeeding, certain medications (including antihistamines, SSRIs, and oral contraceptives), breast cancer treatment, endometriosis treatments, and conditions like Sjögren’s Syndrome. It can also occur during sex due to insufficient foreplay or arousal.

Is vaginal dryness related to vaginismus?

It can be. Vaginal dryness can contribute to pain during penetration, which over time may cause the pelvic floor muscles to tighten in anticipation of discomfort — a pattern that can overlap with vaginismus. For a full overview of vaginismus and how it relates to vaginal dryness and painful sex, see our Vaginismus Overview.

What is the best treatment for vaginal dryness?

First-line treatment typically includes daily vaginal moisturizers and water-based lubricants used during intimacy. Look for formulas with hyaluronic acid and vitamin E, and avoid flavored lubricants that contain sugar. When dryness is accompanied by pelvic floor tightening or painful sex, dilation therapy may also be appropriate. Our article on how to use lube with Milli explains lubricant types and what is compatible with a silicone dilator.

Can vaginal dryness cause pain during sex?

Yes. Vaginal dryness reduces natural lubrication, which increases friction during penetration and can cause burning, soreness, and pain. Persistent pain during sex is called dyspareunia. If pain with intercourse continues despite using lubricant, speak with your healthcare provider, as there may be an underlying cause that needs to be addressed. For more on the causes of painful sex, see our article on dyspareunia symptoms and causes.

Can I use any lubricant with Milli?

No — only water-based lubricant should be used with Milli. Silicone- and oil-based lubricants can damage Milli’s silicone surface. Water-based lubricants are easy to wash off with mild soap and water and are compatible with all silicone-coated devices. For full guidance on lubricant types and how to use them with Milli, see our article How to Use Lube With Milli.

Sources 

• Currie, H. (2023). Vaginal dryness and sexual health in women unrelated to menopause. 

• Dennerstein, L., Dudley, E., & Burger, H. (2000). Are changes in sexual functioning during midlife due to aging or menopause? Fertility and Sterility, 74(3), 549–554. 

• Faubion, S. S., Shuster, L. T., & Bharucha, A. E. (2021). Recognition and management of nonrelaxing pelvic floor dysfunction. Mayo Clinic Proceedings, 86(2), 187–198. 

• Jokar, A., Davari, T., Asadi, N., Ahmadi, F., & Foruhari, S. (2023). Comparison of the hyaluronic acid vaginal cream and conjugated estrogen used in treatment of vaginal atrophy of menopause women. Journal of Clinical and Diagnostic Research. 

• Materna Medical. (n.d.). Milli clinical study data [Data on file]. 

• Nguyen, J. D., & Duong, H. (2024). Vaginismus. StatPearls. 

• Portman, D. J., & Gass, M. L. (2014). Genitourinary syndrome of menopause: New terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the Menopause Society. Menopause, 21(10), 1063–1068. 

• TeleDirectMD. (2026). Medications and vaginal dryness: SSRIs, antihistamines, and hormonal effects. https://www.teledirectmd.com