Integrative Solutions for Vaginal Dryness

May 16, 2023
Integrative Solutions for Vaginal Dryness
Vaginal dryness, common in menopause, causes discomfort, painful sex, and affects intimacy. Estrogen is crucial for vaginal hydration, and its decline causes genitourinary symptoms. This impacts women's quality of life, regardless of age.

Vaginal dryness can happen at any age, but it is one of the most common symptoms women experience with menopause. Estrogen is critical in keeping the skin hydrated, plump, and lubricated. As levels decline, women may experience discomfort, painful sex, and other genitourinary symptoms. Moreover, vaginal dryness affects intimate relationships and quality of life.

While vaginal dryness likely affects 50% or more of women, only about half are treated. Vaginal dryness may be uncomfortable to talk about with a doctor, or women may think it’s another uncomfortable symptom they must live with.

While many menopausal symptoms subside after perimenopause and the first year or two post-menopause, vaginal dryness tends to stick around. The good news is several integrative treatment options restore the health of vulvar and vaginal skin effectively and safely.

Keep reading to learn more about vaginal dryness, the link to declining estrogen, and how to improve comfort and quality of life.

Vaginal Dryness and Estrogen

Dryness may occur internally in the vagina and externally on the vulva due to a thinning and drying of the tissue. Vaginal dryness is the most prominent symptom of a broader condition called Genitourinary Syndrome of Menopause (formerly vaginal atrophy) which includes changes in the vulva, vagina, bladder, urethra, and pelvic floor muscles.

Symptoms of Genitourinary Syndrome of Menopause (GSM) may include:

  • Vaginal dryness
  • Decreased vaginal lubrication
  • Itching and irritation of the vulva or vagina
  • Pain with sex
  • Painful tearing (skin fissures)
  • Increased or urgent urination
  • Pelvic floor weakness and incontinence
  • Urinary tract infections
  • Vaginal infections
  • Bladder, vaginal, or rectal prolapse

The commonality between all these symptoms is low estrogen. During the reproductive years, abundant estrogen helps maintain muscle tone, a healthy vaginal microbiome, lubrication, and healthy skin. As it declines, the skin changes, you lose muscle tone and you are more prone to dryness and infections.

All women go through menopause, and it’s the most common time to experience these symptoms. However, vaginal dryness and other associated symptoms of low estrogen may occur:

  • During the postpartum period
  • After an oophorectomy (the removal of one or both ovaries)
  • With chemotherapy
  • With the use of estrogen-blocking medications after cancer treatment
  • With the use of oral contraceptives, which turns down natural estrogen production

With low estrogen, some women may not experience vaginal dryness, while others may have mild discomfort or severe symptoms.

Vaginal Dryness Solutions

No matter your age, if you are experiencing vaginal dryness and other symptoms of GSM, there are several integrative treatment options to discuss with your doctor. If your doctor is dismissive or uneducated in this area, find someone who is or visit us at TaraMD. We can help you navigate the best, personalized treatment strategy.

Solutions for vaginal dryness include:

  • Bioidentical hormone therapy – Topical or vaginal estrogen cream delivers estrogen directly to the skin that needs it and works quickly to restore skin integrity and balance. It’s also an incredibly safe option, even for women who otherwise might not choose hormone therapy. It has a local effect and very little estrogen makes it into the systemic circulation.

In addition, some women may consider systemic bioidentical hormones for body-wide benefits, especially if experiencing other menopausal symptoms such as hot flashes, bone loss, and decreased quality of life.

Both of these options require a prescription and follow-up with your healthcare provider.

  • Topical DHEA cream – DHEA is the hormone precursor to estrogen and comes in creams that you can apply to the vulva to help strengthen and tone the skin. While the FDA considers DHEA a supplement, since it is a hormone, you need a prescription.


  • Topical phytoestrogens – Phytoestrogens are plant compounds that bind to estrogen receptors in the body and modulate the estrogen response. During times of low estrogen, like menopause, phytoestrogens offer a natural solution to many low estrogen symptoms.

You can eat phytoestrogen foods like flax seeds and organic soy or use supplements. For targeted vaginal dryness support, you can also try topical preparations of phytoestrogen herbs, such as Pueraria mirifica.

  • Non-hormonal creams – There are many non-hormonal vaginal moisturizers on the market. Vaginal moisturizers containing hyaluronic acid are effective for hydrating the skin. In addition, use a lubricant to improve the comfort of sex. Be sure to choose natural and safe ingredients while avoiding fragrances and toxic chemicals that can absorb into the body and upset the microbial balance.


  • Avoid irritation – Avoid irritating or scented soaps, scented toilet paper, and harsh products. In fact, you only need to wash your vulva with water and no need to wash your vagina at all. Wear breathable cotton underwear and follow other common-sense practices.


  • Strengthen your pelvic floor – A decrease in estrogen can affect the pelvic floor muscles, but it’s not the only factor. Working with a pelvic floor therapist is a helpful strategy or try this 20 minute Pelvic Floor Workout with Master Pilates Instructor Ashley Patten (psst, we got you a deal! Enter code TaraMD to try this class for free). In addition, we offer Sola Pelvic Therapy, which is particularly helpful for pelvic, vulvar, or vaginal pain. To be clear, Sola Pelvic Therapy is indicated for pain, not a weak pelvic floor.

While losing estrogen isn’t always a walk in the park, there are many ways to address vaginal dryness and associated symptoms with simple, integrative, and practical solutions. If you are ready for more comfort, lubrication, and to enhance your quality of life, reach out today!