Vaginal Atrophy: Symptoms, Relief & Your Complete Lubricant Guide

By Dr. Michael Krychman, MD

Founder & Executive Director SoCal Center for Sexual Health and Survivorship Medicine, Clinical Health Professor University of California Irvine

“I’m really suffering here… how do I even bring this up—dryness… down there—with my healthcare provider?”

Why Vaginal Atrophy Is Often Ignored

Many women quietly struggle with vaginal dryness, unsure how to bring it up—even with their healthcare provider.

I hear this often from patients who have already seen multiple providers without getting answers. There’s a common assumption that if vaginal dryness during menopause—or after treatments like breast cancer—were important, a healthcare professional would naturally start the conversation.

But that rarely happens.

Instead, both patients and providers remain silent. Many healthcare professionals receive limited training in sexual health and may feel uncomfortable raising the topic. At the same time, appointments are often rushed, with a long list of concerns to cover. Providers may assume that if vaginal dryness or discomfort is significant, the patient will mention it first.

The result? The conversation never happens—and symptoms go unrecognized and untreated.

How Common Is Vaginal Dryness?

Vaginal dryness is far more common than many realize. It can affect women at different stages of life—not just during menopause.

You may experience vaginal dryness if you:

Are breastfeeding
Are taking certain medications (over 300 are linked to dryness, including allergy medications and oral contraceptives)
Have underlying medical conditions such as autoimmune disorders

However, the most common cause is declining estrogen levels during menopause, which can lead to vaginal atrophy (also known as genitourinary syndrome of menopause).

While hot flashes are widely recognized, vaginal dryness is often overlooked—even though it affects up to 50% of menopausal women. Unlike some menopausal symptoms, vaginal atrophy is typically progressive, meaning it can worsen over time if left untreated.

Why Early Treatment Matters

Without proper support, vaginal dryness can lead to ongoing discomfort, irritation, and pain—especially during intimacy or everyday activities.

The good news is that relief is available.

For many women, a well-formulated personal lubricant can provide immediate support by reducing friction and improving comfort during intimacy, tampon use, or pelvic floor therapy. However, not all lubricants are created equal.

Choosing the right product is essential—not just for comfort, but for supporting long-term vaginal health.

Vaginal Atrophy Symptoms

Vaginal atrophy symptoms can vary from mild to severe—and often worsen over time if left untreated.

Common symptoms include:

Vaginal pain, discomfort, or irritation
Pain or heat in the vulvar and vaginal area
Burning or stinging
Fear of pelvic and digital examinations
Painful intercourse (dyspareunia)
Paper cut-like tears at the vaginal opening
Bleeding or vaginal spotting with minimal contact

Vaginal Atrophy and Menopause

In addition to vaginal symptoms, many women also experience urinary changes as part of vaginal atrophy and menopause.

These may include:

Burning with urination (dysuria)
Increased urinary frequency or urgency
Night-time urination (nocturia)
Recurrent urinary tract infections (UTIs)
Blood in the urine (hematuria)
Noticeable odour during urination

Hormonal changes can also increase the risk of vaginal infections such as:

Bacterial vaginosis
Yeast infections (candidiasis)

How Vaginal Atrophy Affects Quality of Life

Vaginal atrophy is not “just dryness”—it can have a significant impact on emotional well-being, relationships, and overall quality of life.

The VIVA Study (Vaginal Health: Insights, Views & Attitudes) found:

75% reported negative effects on their sexual lives
68% reported that it made them feel less sexual or attractive
36% reported that it made them feel old
33% reported strain in their relationships
25% reported lower sexual self-esteem

Similarly, the REVIVE Study (Real Women’s Views of Treatment Options for Menopausal Vaginal Changes) surveying 3,000 American women with vulvovaginal atrophy found:

85% of women with a partner indicated it negatively affected intimacy
59% reported reduced sexual enjoyment
47% reported it impacted their relationship
27% reported reduced overall quality of life

The takeaway: Vaginal atrophy can affect far more than physical comfort—it impacts confidence, intimacy, and daily life.

Choosing the Right Lubricant

Choosing the right lubricant for sexual activity can feel overwhelming—but it doesn’t have to be.

With so many options available, understanding the differences can help you make a more informed choice. Not all lubricants work the same way, and one type may not suit every need or situation.

Having a few options on hand allows you to find what feels best for your body and your comfort. Exploring different types can enhance ease, confidence, and overall enjoyment—especially when managing vaginal dryness or sensitivity.

Oils and Oil-based Lubricant

Not typically recommended
Can disrupt vaginal pH and increase infection risk
May damage latex products

Water-Based Lubricant

Easy to find and widely used
Often contain de-ionized water and/or glycerin or propylene glycol
Generally safe to use with silicone/latex products
Must be reapplied, as they can dry out with extended activity

Silicone-Based Lubricant

Longer-lasting and more slippery than water-based products with less need to re-apply
Ideal for prolonged intimacy or severe dryness
Ideal when menopause and andropause collide
Excellent for use in water (shower, bath)
Tasteless, odorless, non-sticky
Do not contain water so they will not adversely influence the vaginal ecosystem
Can be used as massage lotions, as they do not dry out
Not always compatible with silicone products

silicone lubricant — A high-quality option like Überlube is widely used due to its smooth, non-sticky feel and simple, body-safe formulation. It provides lasting comfort without the need for frequent reapplication, making it especially helpful during menopause or for those experiencing persistent dryness.

Hybrid Lubricants

Combine water and silicone
Offer both comfort and longevity

Flavored/Warming Enhanced Lubricant

Can enhance sensation
May cause burning or irritation for those with sensitive/dry tissues

Pantry Solutions

Examples include extra virgin and coconut, vegetable, avocado or peanut oil
Most healthcare professionals frown upon using food products within the vagina area since they have been linked to increased vaginal infections that may be persistent and difficult to treat

Breaking the Silence: How to Get Help

Starting the conversation can feel uncomfortable—but it’s one of the most important steps toward relief.

Here’s how to make it easier:

Prepare in advance: Write down your symptoms and concerns. It may be helpful to practice and run through some scenarios in your head
Use your care team: Nurses or assistants can help bridge the conversation. It’s also okay to mention your concerns to them and have them relay your concerns to the doctor
Stay engaged: Ask questions and make sure your concerns are addressed

You deserve answers—and support.

Dr. Michael Krychman is a clinical health professor at the University of California Irvine, where he maintains a clinical practice of complex gynaecology at the Ann’s Center, a High Risk Breast and Ovarian cancer center. He specializes in cancer survivorship, vulvar disease, and comprehensive care for those with chronic disease and focuses on quality-of-life concerns. He is also the Founder & Executive Director of SoCal Center for Sexual Health and Survivorship Medicine. He is a thought leader, Fem Tech expert, medical and scientific advisor, and executive board member.