Does hormone replacement therapy help with vaginal dryness?

When oestrogen levels fall, vaginal tissues can become thinner, less flexible and less naturally lubricated. This can cause burning, irritation, discomfort during sex or urinary symptoms. Hormone replacement therapy may improve the underlying tissue changes when they are related to menopause. Some people may need a vaginal form of oestrogen applied locally, while others may consider treatment that affects the whole body. Vaginal dryness can also follow medicines, breastfeeding, skin conditions or irritation, so the explanation is not always hormonal.

Track when dryness occurs, whether sex or urination makes it worse, and any discharge, itching or bleeding. A clinician can discuss moisturisers for regular comfort, lubricants for sexual activity and whether local or systemic hormone treatment fits your needs. Do not use scented washes or douches inside the vagina, because they can increase irritation. Tell the clinician about a history of blood clots, unexplained bleeding, hormone-sensitive cancer, liver disease or migraine before discussing hormones.

Arrange an assessment for persistent dryness, pain, repeated urinary symptoms or symptoms that interfere with sleep, movement or intimacy. Seek prompt medical advice for bleeding after sex, new bleeding after menopause, sores, marked swelling, fever or unusual discharge with a strong smell. These features can have causes that need examination rather than treatment based on dryness alone.

Could my dryness have a cause other than lower oestrogen? Would a local treatment be suitable for my symptoms? What warning signs should I watch for, and how should I use a lubricant or moisturiser alongside treatment?