Menopause is widely associated with uncomfortable hot flashes, but many women also suffer from vaginal dryness during and after menopause (Climacteric, March 3, 2016). When tissues of the vulva and vagina atrophy, women may find sexual intercourse painful. Needless to say, this can create difficulties with their partners, undermining important relationships. Doctors frequently prescribe estrogen to overcome vaginal dryness, either as pills or as vaginal creams or Estring (estradiol intravaginal ring). Another option is a softgel vaginal insert containing estradiol (Menopause, Aug. 19, 2019). However, women who have had breast cancer and those who have a family history of breast cancer may be reluctant to use estrogen. They might prefer natural approaches to manage this problem.
Cocoa Butter for Vaginal Dryness?
Q. My gynecologist recommended cocoa butter wafers to overcome vaginal dryness. I bought some online. He told me to insert one at bedtime (I use half a wafer). It melts quickly and really works.
I have one issue, though. Although I love the smell of chocolate, it is a bit weird having that bag of cocoa butter wafers in the bedroom/bathroom – sure does have a strong smell of chocolate!
A. We could find no research supporting cocoa butter as a vaginal lubricant. That said, the third edition of the book, Diagnostic Gynecologic and Obstetric Pathology (2018) does mention it for the management of atrophic vaginitis.
“Some authorities recommend topical application of cocoa butter, beeswax, or mineral oil to aid with sexual activity. These should be used with caution because they may clog the pores.”
We don’t have a solution for the smell of chocolate!
The Harvard Women’s Health Watch (June 19, 2019) mentions olive oil as a natural vaginal lubricant. Like cocoa butter, it may also serve as a moisturizer to be applied daily and not only prior to intercourse. Some women are allergic to topical olive oil, however. A woman who is considering using olive oil (or other natural moisturizer to overcome vaginal dryness) should test it on the skin of her forearm before placing it in any sensitive areas.
Other Natural Approaches:
Many women report that coconut oil is useful as a vaginal moisturizer. Others like to use aloe vera gel as a lubricant. One commercial product, Sylk, contains kiwifruit extract and is water-based. This may be important for couples using condoms, as olive oil, mineral oil, coconut oil or even cocoa butter can damage latex. Lubricants such as Astroglide, Bioglide, Balance Activ or Good Clean Love Lubricant may be more appropriate when latex comes into play. Some of these may cause irritation, however, so it makes sense for a woman to try a few to see which one suits her best. She may also want to inquire about pelvic floor muscle training, as this can help with the symptoms of vaginal dryness and may also be beneficial for urinary problems (Frontiers in Endocrinology, online Aug. 21, 2019).