Let’s talk about something that deserves way more airtime: vaginal dryness during perimenopause. Yep, we’re going there, because pretending it’s not happening helps exactly no one.
One day, everything’s fine… and the next? Sex feels like sandpaper, your favorite underwear suddenly feels like it’s plotting against you, and you’re wondering, who hijacked my lady parts?
Here’s the truth: you’re not broken, and you’re not alone. Vaginal dryness is a totally normal (and frustrating) part of the hormone rollercoaster that is perimenopause. But just because it’s common doesn’t mean you have to suffer through it in silence. There are solutions, real, science-backed ones, and reclaiming your comfort is 100% possible.
It’s time to stop whispering and start solving. So let’s go!.
What Causes Vaginal Dryness in Perimenopause?
The main reason is hormonal changes, particularly the decline in estrogen levels. Estrogen is vital for maintaining the health of vaginal tissues, helping to keep them:
- Thick and elastic
- Well-lubricated
- Resistant to irritation and infection
When estrogen declines (which starts happening in perimenopause, often as early as your 40s), the vaginal walls become thinner, drier, and more fragile, a condition called genitourinary syndrome of menopause (GSM), formerly called vulvovaginal atrophy.
According to the North American Menopause Society (NAMS), over 50% of women in perimenopause and menopause experience vaginal dryness, and yet most never talk about it with their healthcare provider.
But it’s not just hormones.
Other contributing factors include:
- Medications: Especially antihistamines, antidepressants, and breast cancer treatments like aromatase inhibitors. Source
- Chronic stress: Elevated cortisol levels suppress sex hormones and reduce vaginal lubrication. Source
- Autoimmune disorders and diabetes can also impair tissue hydration and healing. Source
- Low arousal or rushing intimacy: Without adequate foreplay, natural lubrication doesn’t have time to build. Source
How can you fix it?
Here’s what you can do, starting today.
1. Lubricants for Comfort During Sex
These are short-acting products that reduce friction during intercourse.
- Water-based lubricants: Safe, versatile, and compatible with condoms and sex toys.
- Silicone-based lubricants: They last longer and are ideal for those who experience significant dryness.
- Avoid products with glycerin or parabens if you’re prone to infections.
Pro Tip:
- Use generously. More is more here, and using lube is not a sign of weakness. It’s smart, sexy, and stress-free.
- Coconut oil as a lubricant: Coconut oil is trendy and has a pleasant scent, but it can disrupt your vaginal microbiome. While it may feel soothing initially, this disruption can lead to yeast infections and irritation, which you’d want to avoid.
If you’re using latex condoms, you should avoid coconut oil. It breaks down latex, which can compromise your protection against sexually transmitted infections (STIs). Additionally, some women may experience allergic reactions or skin sensitivity to coconut oil, making it uncomfortable to use. Remember, just because something is natural doesn’t mean it’s safe. There are better, body-safe alternatives available, especially if you’re already dealing with the hormonal changes of perimenopause.
2. Vaginal Moisturizers for Daily Hydration
These are not the same as lubricants.
- Moisturizers, such as Replens or Hyalo Gyn, mimic natural secretions and help restore vaginal pH and elasticity.
- Use 2–3 times a week consistently for best results.
- Some even contain hyaluronic acid, which improves hydration and tissue repair.
3. Local Estrogen Therapy
If dryness is severe or persistent, this is often the most effective route.
- Options include vaginal creams, tablets, suppositories, or rings (like Estrace, Vagifem, or Estring).
- These deliver estrogen directly to the vaginal tissue without significantly raising systemic hormone levels.
- According to NAMS and ACOG (American College of Obstetricians and Gynecologists), these therapies are safe for most women, even those who cannot use systemic HRT.
Always consult with a hormone-literate provider, especially if you have a history of breast cancer.
4. Foreplay, Arousal & Communication
Arousal increases blood flow to the pelvic area and boosts natural lubrication.
- Slow down, engage in activities that build connection and pleasure.
- Use external stimulation or vibrators to enhance sensation.
- Most importantly, talk to your partner. Let them know what feels good and what doesn’t.
5. Hydration & Anti-inflammatory Support
Your vaginal tissues are part of your whole body. Treat them that way.
- Drink at least 2 liters of water daily or ½ your body weight in Oz’s.
- Reduce alcohol and caffeine, which are dehydrating and can trigger hot flashes.
- Focus on anti-inflammatory foods: omega-3 fats, leafy greens, berries, turmeric, etc.
- Lower cortisol with stress-reduction practices: breathwork, yoga, walking in nature, EFT tapping
“But Charlie, I still feel embarrassed…” Aw, my dearest love, you’re not alone. But you also don’t have to suffer silently. Many women feel that dryness means they’ve lost their sex drive, or that they’re no longer desirable. That’s not true. Desire isn’t gone, it just needs different support.
Dryness is a physical symptom, not a reflection of your femininity, libido, or worth as a wonderfully made woman!
Time to See a Provider If:
You experience burning, itching, or bleeding
- Over-the-counter solutions don’t help
- Sex is painful, no matter what you try
- You feel embarrassed or confused and want real answers
- And, if you haven’t yet had a menopause care visit
Find a provider trained in menopause support, someone who listens, understands, and offers modern, evidence-based solutions.
Final Thoughts: You Deserve Comfort and Confidence
Vaginal dryness is a normal part of this life phase, but it doesn’t have to derail your joy, intimacy, or identity. With science-backed tools, loving self-care, and support from someone who gets it, you can reclaim this part of your life and feel at home in your body again. Let this be your permission slip: you are not drying up, you are transforming. And yes, you can feel sexy, vibrant, and fully alive again.
Got questions about your perimenopause journey? You’re not alone, and you don’t have to figure it out by yourself. This is your safe space to ask anything, from mood swings to metabolism, weight gain to wine guilt, and get real answers, live support, and practical tips tailored to YOU. Click here to join us for Facebook Live Office Hours with The Menopause Coach every Wednesday at 1 PM EST inside the group!
Whether you just took the It Might Be Menopause Quiz or downloaded Eat for Hormone Love, 5 day recipe Guide this is your next best step.
Let’s make your hormones make sense, together. Set your reminder: Wednesdays @ 1PM EST Inside The Joy of Menopause Facebook Community. Come say hi, bring your questions, or just listen in. You’ll leave feeling seen, supported, and one step closer to balance.