Although we may not always be comfortable talking about it, the truth is that many of us are dealing with vaginal dryness and potentially its associated symptoms of burning, irritation or pain with sex.
Looking at data of more than 2,400 women over a period of 17 years, the Study of Women’s Health Across the Nation (SWAN) found that over 19% of women aged 42–53 were experiencing vaginal dryness at the beginning of the study. By the time all study participants reached the ages of 57-69, that number grew to 34%.1
Given how common vaginal dryness is — especially during and after menopause — it’s perhaps unsurprising that so many products exist claiming to relieve it. But trying to choose one may leave you with more questions than answers. Should you purchase a vaginal moisturizer or a lubricant? Or do you need both? How and when should they be used?
Understanding the differences between vaginal moisturizers and lubricants may help you decide which one is best for your unique needs, so let’s dive into some specifics.
What Causes Women to Need a Vaginal Lubricant or Moisturizer?
“Many women will experience a lack of lubrication and require a vaginal lubricant during sexual intimacy at one point or another – with the most common symptoms being pain, burning, itchiness or discomfort during sex,” says Dr. Michael L. Krychman, MDCM, Executive Director of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach, California. “Some others may also complain of lack of arousal or diminished arousal during sexual intimacy or intercourse, as well.”
Because a loss of estrogen that begins during perimenopause can cause vaginal tissue to become thin and dry,2 many women may find themselves reaching for vaginal moisturizers or lubricants during this time. “About 50% of women will experience vaginal dryness during and through the menopausal transition,3 and this is often considered to be a chronic and progressive symptom,” Dr. Krychman advises.
Approximately 17% of women between the ages of 18 and 50 may also experience vaginal dryness that’s not related to hormone changes that occur during the menopausal transition.4 Other than estrogen loss, some of the most common causes of vaginal dryness may include:5
- Lack of arousal during sex
- Irritating hygiene products, such as harsh soaps or anything heavily fragranced
- Certain drugs such as allergy medicine and birth control pills
- Cancer treatments, such as chemotherapy and/or adjuvant medication (aromatase inhibitors)
- Breastfeeding on demand
Whatever the cause, vaginal symptoms, such as dryness, can have an effect that extends far beyond the bedroom. “Vaginal dryness, irritation, burning and pain are not only about intercourse/intimacy, but they also have a huge impact on quality of life and can even affect activities of daily living,” Dr. Krychman says.
What’s The Difference Between Vaginal Lubricants and Moisturizers?
Although both vaginal lubricants and moisturizers are used to relieve symptoms such as vaginal dryness, burning and pain with intercourse they are distinct products designed to serve different purposes.
When to Use a Personal Lubricant and What to Look For
In general, vaginal lubricants are meant to provide immediate, short-term relief from vaginal dryness during intimacy. “I associate lubricants with lovemaking – meaning they are used during sexual intimacy, on demand, and often during sex play or intercourse,” Dr. Krychman says. He continues to explain that lubricants can help ease the discomfort that can accompany penetration when women are dealing with vaginal dryness during menopause.
“Sexual intercourse itself may also help to support vaginal health; more specifically, it can aid in maintaining elasticity,” Dr. Krychman says. “With lubricants, sex becomes more comfortable, so sex itself can be considered to be part of the treatment [when it comes to dryness or pain on insertion].”
Vaginal lubricants are generally categorized according to their ingredients and can be water-based, silicone-based, oil-based or a hybrid.
Water-based lubricants are safe to use with latex condoms and are easy to clean up with soap and water, but they can dry up quickly, don’t work underwater and sometimes contain harsh ingredients.6 “Water-based lubricants may have additives, which can be caustic and irritating to the vaginal lining,” Dr. Krychman cautions.
He often recommends silicone-based lubricants, such as Uberlube, that don’t affect vaginal pH, can be used in water and can be used with latex condoms.
While oil-based lubes are a popular choice, it’s crucial to note that they aren’t safe to use with latex condoms and may degrade the integrity.7This includes lubricating products like coconut oil or even olive oil. If you’re unsure about what to look for in terms of lubricant ingredients, be sure to check in with your healthcare provider.
No matter which type of lubricant you’re considering, Dr. Krychman suggests checking the label. “Some troublesome ingredients can be hidden in the list,” he advises. “It’s also important to avoid flavors, warming ingredients, colors, as well as bactericides or spermicides, since they can irritate the underlying [vaginal] mucosa.”
How to Choose and Use a Vaginal Moisturizer
While lubricants are made to serve an immediate need, vaginal moisturizers are designed to provide longer-term relief from vaginal dryness and its symptoms.
“Think of moisturizers as a way to maintain,” Dr. Krychman explains. “Vaginal moisturizers are used more often — and on a continuous basis — to support the ridges and folds of the vagina, as well as its elasticity and pliability, which are correlated to vaginal symptoms. They are often used independently of intercourse.”
When it comes to choosing a vaginal moisturizer, Dr. Krychman and other experts recommend products that contain hyaluronic acid. Research has shown this ingredient is highly effective for soothing vaginal dryness and associated irritation.8
“Hyaluronic acid has incredible hydration properties and is also a naturally occurring molecule in the body,” Dr. Krychman says. “My go-to moisturizer is Revaree® vaginal suppositories that contain hyaluronic acid and can be used regularly 2-3 times a week.”
When to See a Healthcare Provider
Whether your vaginal dryness is related to menopause or something else, Dr. Krychman suggests getting help if your symptoms are disrupting your life.
“Sexual intimacy and intercourse should be focused on interpersonal connection and pleasure, and when pain and discomfort appear and become disruptive, it’s time to get answers,” Dr. Krychman says.
He adds that women who are concerned about symptoms such as burning, pain or discomfort in the perineal/vaginal area should seek medical advice and get a proper evaluation.
“While vaginal dryness is very common, it is important to rule out other conditions that may be impactful on vaginal health,” Dr. Krychman says.