Vaginal dryness & Sexual dysfunction during menopause.
Dr. Saloni Manwani

Dr. Saloni Manwani

Jan 09Sexual health

Vaginal dryness & Sexual dysfunction during menopause.

What happens to the vagina during menopause?

Your vagina can experience significant changes with the start of menopause. 

Dry and itchy vagina

Under normal circumstances, a layer of thin clear fluid that is secreted due to oestrogen, keeps the vagina well lubricated and prevents dryness.

A sudden drop in the estrogen levels during menopause reduces the secretion of these vaginal fluids.Less or no moisture can cause irritation and discomfort in the vaginal area.

Vaginal atrophy 

Oestrogen also helps in maintaining the vaginal lining healthy, thick and elastic. The lack of oestrogen causes vaginal atrophy, a condition in which the vaginal walls become thinner and less flexible.

Painful intercourse

The loss of oestrogen makes the blood vessels in the vaginal walls narrower. Over some time, the vagina shrinks in size and loses its flexibility or elasticity, which is essential for comfortable sexual intercourse. Furthermore, vaginal dryness during sex can make it really painful.

Increased chances of infection

The vaginal pH becomes more alkaline due to oestrogen deficiency and increases the chances of inflammation of vagina and infections such as yeast, bacterial vaginosis, trichomonas vaginitis.

Vagina becomes prone to bleeding

The thinning of the vaginal walls makes the vagina fragile and becomes prone to tears and bleeding upon minor trauma.

Sexual Dysfunction during Menopause

Along with significant and visible changes in the vagina, you may also notice changes in your sexual drive. If you are having trouble experiencing satisfaction from sexual activities, you may be going through sexual dysfunction, another common side effect of menopause.

During sexual dysfunction, you may experience the following symptoms:

  • You may not feel the desire to engage in sexual activity.
  • You may not get easily aroused or achieve an orgasm.
  • You may experience pain during sexual activity.
  • There may be an involuntary tightening of the muscles around your vagina.
  • You may be less sensitive to genital arousal.

All of this can affect the couple’s sex life as the male partner may not be aware of the exact reasons for the sudden sexual disinterest and discomfort that the woman may be going through. It can cause misunderstanding and fights between the couple. Therefore, the males too need to be made aware of these changes that can occur during menopause, so that they are well prepared and supportive of their partner.

Vaginal dryness & Sexual dysfunction

Why does sexual dysfunction happen during menopause?

Sexual dysfunction can happen due to many reasons like lack of estrogen, emotional changes during menopause and certain medical conditions as well.

Estrogen deficiency: As mentioned earlier, the declining estrogen levels during menopause are one of the major causes of reduced lubrication in vagina and causes the vaginal walls to become fragile and thin. The blood flow to the vagina responsible for increased sexual arousal also reduces upon the onset of menopause. The changes can cause pain during intercourse.

Psychological factors: Menopause not only impacts the physical health but also mental health. You may find it difficult to accept the drastic body changes and may develop a critical opinion about your body image. You might even lose self-confidence and sexual confidence due to the pain and discomfort caused by vaginal dryness. It may make you stressed and emotionally disturbed and ultimately affect your sexual function.

Medical conditions: Aging can be difficult as the body becomes prone to various medical conditions like arthritis, hip or lumbar joint pain. These problems may contribute to vaginal or pelvic pain during sexual intercourse.

What are the treatments for vaginal dryness and sexual dysfunction during menopause?

Hormonal Replacement Therapy 

Oestrogen replacement is one of the most common vaginal dryness treatments. It is available in many forms like vaginal creams, vaginal tablets, vaginal rings or oral tablets. You can consume whatever suits your body the best or as per your doctor’s advice. It can help your body cope with the immense oestrogen loss and vaginal dryness.


Since the vagina is unable to produce vaginal fluids that help in comfortable intercourse and vaginal stimulation, you can consider using lubricants for vagina to reduce uncomfortable pain and increase pleasure. You must research well about the different lubricants to choose the appropriate one for you.

Note: Use of certain products like perfumed soaps and moisturisers, talcum powder in the genital areas can further increase the vaginal dryness and itchiness. Hence, you must avoid using these products. Self-prescribed over the counter products for dry vagina treatment are also not recommended as it can have adverse effects on your body. Similarly, do not use any products that are not for vaginal use.

How can you improve your sexual intimacy with your partner after menopause?

Menopause may hamper your sex life. You may not be able to experience pleasure during sexual activities as before. But, this is the time you should not hesitate to communicate, explore and experiment with new techniques that can work best for you and your partner.

Self-awareness and communication with your partner

First, recognise and accept the bodily changes happening in your body during the menopause transition, stages of menopause and postmenopause. Once you do this, it will be easy for you to explain them to your partner and eliminate any chances of misunderstanding. Also, the fact that these changes are treatable is reassuring for the couple.

Treatments for vaginal dryness and sexual dysfunction 

With the advice of your doctor, you can consider Estrogen Replacement Therapy, other recommended medications or lubricants for vagina for coping with the estrogen loss and increase sexual arousal.

Experiment with new methods and focus on foreplay

You can incorporate the use of erotic videos or books, vibrators and sex toys to enhance sexual stimulation. As sex can be painful due to the vaginal changes, you can focus on foreplay and sensual massages. Taking the advice of a sex therapist can also be beneficial to bring in a new sense of intimacy.

Engage in mind-body activities

You can perform mind-body activities like yoga, meditation, acupuncture and tai chi to relieve the symptoms that interfere with sexual intimacy, sexual desire and sleep quality.

When should you see a doctor?

Menopause is not the only reason behind vaginal dryness; it is also a symptom of Sexually Transmitted Infections (STIs). Hence if you notice any changes in your vagina, it is advisable to visit a doctor before self-prescribing female dryness cure medications that may worsen the symptoms.

Moreover, counseling about the changes during menopause and menopause support groups can help you adapt to the changes better.

Disclaimer: This information is educational and should not be construed as medical advice. Please consult your doctor before making any dietary changes or adding supplements.

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