Vaginal Moisturizers and Lubricants

You have choices when it comes to easing vaginal dryness, a common and irritating symptom of menopause — whether you go through natural menopause or early menopause during or after breast cancer treatment. Vaginal lubricants and moisturizers are not the same, but each can play a role in helping to ease vaginal dryness.

The normal dip in levels of the hormone estrogen as women get older can cause the lining inside and around the vagina to thin out and become less flexible or elastic. Women who’ve had their ovaries removed surgically can go into menopause abruptly. So can women who take Tamoxifen or an aromatase inhibitor — medicines that reduce the amount of estrogen in the body — to treat estrogen receptor-positive breast cancer. Sometimes menopause brought on by cancer treatment can cause symptoms that are more dramatic than when menopause happens naturally, says Mindy Schiffman, PhD, a New York-based clinical psychologist and sex therapist, because the change is sudden rather than gradual.

Vaginal moisturizers, such as the brand Replens or single-agent coconut oil, are different from lubricants because instead of sitting on the skin’s surface, they are absorbed by the skin.

(A note about coconut oil: some are what's called "fractionated," which means they have ingredients other than coconut oil. There are also coconut-oil based personal lubricants that contain other ingredients. Use only pure 100% coconut oil with no other ingredients.)

Moisturizers work to trap and hold moisture in skin tissue. “Vaginal moisturizers are specifically formulated for delicate vaginal tissue. When vaginal skin becomes thinner and drier, it’s more vulnerable to irritation, even tearing,” says Sharon Bober, PhD, senior psychologist, and director of the Sexual Health Program at the Dana-Farber Cancer Institute in Boston. "Women may experience pain during sexual activity. Also, dryness, itching, and chafing can cause discomfort even during normal daily activities."

If you have vaginal dryness and irritation, whether it’s brought on by natural or breast cancer treatment-induced menopause, a moisturizer can be a big help. “Vaginal dryness isn’t a symptom that gets better on its own, so it’s smart to actively treat it,” Bober says.

Like lubricants, vaginal moisturizers don’t increase a lowered libido, but they can do two things. First, in the short term, using a vaginal moisturizer can ease itching and irritation. Second, when used regularly, a vaginal moisturizer can help improve the integrity of vaginal tissue, helping it stay more supple and flexible and less prone to injury, such as tearing.

There are many types of vaginal moisturizers, including gels or creams that you can put inside your vagina with a disposable applicator (usually the size and shape of a tampon), or with your clean hands. Doctors recommend moisturizers with hyaluronic acid because they pull moisture from the environment and into the tissues they're applied to. There are also pill-shaped inserts called suppositories that you place inside the vagina and that melt and are absorbed into the skin. You can buy these products over the counter, without a prescription, and they don’t contain estrogen or other hormones.

Regardless of which type of vaginal moisturizer you choose, make sure it is non-irritating and fragrance-free, Bober says: “It can take some experimentation to find what’s best for you. Be sure it doesn’t contain phthalates — hormone disruptors, so they don’t mimic hormones but can disrupt the balance of hormones in your body — or parabens, which can penetrate the skin and act like a very weak estrogen in the body. Evidence seems to point to the use of hyaluronic acid-based moisturizers as being the most effective option.”

Vaginal moisturizers work best when used consistently, says Dr. Bober. One study showed that using a vaginal moisturizer after menopause greatly improved the elasticity and suppleness of vaginal tissue. ¹

Tips on how to use vaginal moisturizers:

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  Using a vaginal moisturizer every day after bathing can be beneficial. The product can either be applied internally or externally depending on your needs. Experiment to see what works best for you.

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  When you use a vaginal moisturizer internally, it’s best to do so at night, to allow the product to dissolve (if it’s a suppository) and become absorbed without leaking out.

Vaginal lubricants, like Astroglide and K-Y Jelly, are over-the-counter products that usually are either water- or silicone-based, but can be oil-based too. Although lubricants don’t increase a lowered libido, using them can make sexual activity easier. “Sex should not be painful,” says Dr. Schiffman, “and a lubricant eases friction that can otherwise cause pain.” It can also be helpful to use a lubricant for sexual touch because it’s possible to be aroused but not feel wet, and a lubricant can help improve the whole experience by making it less painful and more enjoyable. 

Tips on how to use lubricants:

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  Experiment to find the lubricant that works best for you. However, if you’re using a condom during sex, you should choose a water-based or silicone-based product. Although you can use pure oil, such as coconut or almond oil, as a lubricant, these can break down the condom, and may also be more irritating to you. Water-based lubricants are also less messy and don’t tend to stain clothing or bedsheets.

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  Avoid lubricants that are advertised as “warming” or that claim to increase sexual arousal if you’re already dry and irritated; these products may contain ingredients that make vaginal dryness worse. The same goes for a lubricant or other product that contains a spermicide.

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  Never use petroleum jelly (such as Vaseline) as a lubricant. It doesn’t wash off easily and can raise your risk of a vaginal infection.