Vaginal dryness and low sex drive: what to know

Reduced oestrogen during perimenopause, menopause, or premature ovarian insufficiency can make vaginal tissue drier and more sensitive. Genitourinary Syndrome of Menopause can include dryness, burning, urinary changes, and discomfort with intimacy. Pain or fear of pain may then reduce desire. Stress, low mood, relationship strain, sleep problems, medicines, and other health conditions can affect desire without causing dryness.

The pattern matters: note when symptoms began, whether periods or breastfeeding changed, whether there is itching or unusual discharge, and whether dryness occurs outside sexual activity.

Arrange a consultation if symptoms persist, interfere with intimacy, or affect daily comfort. A clinician can review medicines and hormonal history and examine the vulval and vaginal tissues when needed. Lubricant during sex and a regular vaginal moisturiser may reduce friction; choose products made for vaginal use and stop any product that stings. Do not assume low desire is caused by dryness alone.

Treatment depends on the cause. Options may include counselling or sex therapy, management of an underlying condition, hormone replacement therapy, or locally applied vaginal oestrogen therapy. A clinician can explain which option fits your health history.

Seek prompt medical advice for bleeding after sex, bleeding after menopause, new sores, marked swelling, fever, foul-smelling discharge, or severe pelvic pain. Arrange assessment for persistent dryness, repeated pain, or symptoms that begin soon after a new medicine. Urgent care is appropriate for severe pain, heavy bleeding, faintness, or feeling acutely unwell.

Ask whether the symptoms fit Genitourinary Syndrome of Menopause, whether a medicine or health condition could be contributing, and which lubricant or moisturiser is suitable. You can also ask how vaginal oestrogen therapy differs from hormone replacement therapy and when improvement should be reviewed.