The People's Perspective on Medicine

Natural Approaches to Overcome Vaginal Dryness

Many women find that lack of lubrication associated with menopause complicates sexual enjoyment. How can they overcome vaginal dryness?
Portrait of a happy romantic couple.

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.

To quote:

“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).

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    About the Author
    Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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    Menopause
    Citations
    • Edwards D & Panay N, "Treating vulvovaginal atrophy/genitourinary syndrome of menopause: How important is vaginal lubricant and moisturizer composition?" Climacteric, March 3, 2016. doi: 10.3109/13697137.2015.1124259
    • Constantine G et al, "Early onset of action with a 17β-estradiol, softgel, vaginal insert for treating vulvar and vaginal atrophy and moderate to severe dyspareunia." Menopause, Aug. 19, 2019. DOI: 10.1097/GME.0000000000001394
    • Nappi RE et al, "Addressing Vulvovaginal Atrophy (VVA)/Genitourinary Syndrome of Menopause (GSM) for healthy aging in women." Frontiers in Endocrinology, online Aug. 21, 2019. doi: 10.3389/fendo.2019.00561
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    I can’t do estradiol—bad headaches, nausea, night sweats. Tried Osphena and while I had no side effects, it didn’t really do anything to help. Replens was fantastic the first time I used it but then almost immediately began irritating the skin badly after. Tried coconut oil, Yes! and others and they either didn’t help or irritated. Then I found Good Clean Love, which comes in a vaginal lubricant and a sex lubricant. You use the vaginal gel a few time a week after an initial two week more frequent application (as I remember). You can also insert some before sex, if lubricant isn’t quite enough. This stuff saved me! The vaginal gel runs about $15/tube in metro Philly area, but it lasts a decent amount of time once you’re just using it just a few times a week. Worth every penny for us extremely sensitive types!

    I have been taking Evista and using Estrace for vaginal dryness for five years. I still suffer from vaginal dryness and started taking Osphena six months ago. Osphena definitely helps vagina dryness but does it provide the protection for Osteoporosis Evista does? Having a family history of both breast cancer and Osteoporosis, I want to be on the safest drug.

    Ospemifene (Osphena) is not prescribed for osteoporosis, but it does improve markers of bone health. Here’s a recent study:
    https://www.ncbi.nlm.nih.gov/pubmed/31294631

    Sea buckthorn works! I’m surprised it wasn’t mentioned in the article. Here is a link to a study: https://www.ncbi.nlm.nih.gov/pubmed/25104582

    Thank you for addressing this issue, as I don’t believe menopausal issues are discussed much or well. However, I’m not sure your article makes clear the difference between vaginal moisturizers and lubricants, the former to be used regularly, and the latter to be used to help with intercourse. And, try as I might, I just can’t figure how strengthening one’s pelvic floor can relieve vaginal dryness. Some kind of Kegel-induced capillary action or what?! The article you cited states that such training could help generally with symptoms of vulvovaginal atrophy and genitourinary syndrome and specifically with urinary incontinence, but does not specify a benefit for vaginal dryness.

    Years ago my mother taught me to use glycerin. I use organically grown vegetable glycerin (#1 or 2 ingredient in most moisturizers) for everything, including lube, and it is also an ingredient in my neti pot solution.

    Good article. Good variety of prescription and natural options. I prefer the Estring ring. And, when needed, Astroglide.

    From an 87 year young women, a crone, to be exact:
    Coconut oil to the rescue. Doesn’t have the side effects of either kind of estrogen, oral or topical, is cheap, over the counter, smells good plus…it works against vaginal dryness.
    I can only imagine it would be effective for fun and games, too. I dont know about chocolate….could combine the 2 I guess.

    I’ve been using Amata Life vaginal moisturizer every day, which contains Pueraria mirifica, a plant used in Asia to relieve symptoms of menopause. It does contain phytoestrogens. Without it, I experience daily discomfort from dryness. I would love to hear if you’ve read any research on pueraria mirifica, also known as kwao krua.

    I got a prescription for estriol vaginal cream twice a week and have a small jar of coconut oil for anytime. I recall Terry saying with this you have an applicator at your fingertips
    I’m 66. This helps a lot, and it smells nice.

    Many thanks for this post. When I first complained about vaginal dryness, my gynecologist didn’t discuss any natural remedies. She immediately wrote a prescription for estradiol cream. It wasn’t in my insurance formulary, so I had to pay full price. And after only one application, I had a very bad headache. My blood pressure shot up and remained high for weeks. If I had applied it one more time, I’m sure I would have had a stroke or heart attack. I take black cohosh now, and that seems to reduce the amount of the foul-smelling vaginal discharge associated with the dryness.

    olive oil!

    I find a very good natural alternative to help with vaginal dryness is to take at least 2 Sea Buckthorn Berry Oil soft gels daily. Been taking them now for last 8 years. I took 4 daily for first few months, then tapered off to 2 daily.

    A daily serving of 2 Tbsp flaxseeds works for me. I buy the whole seeds and grind them myself and mix them in my yogurt or smoothie.

    All of these solutions are similar in that a substance is being used for lubrication at the time of sex. My vaginal atrophy is so bad that when I don’t use my estradiol suppository every other day, within a week the dryness becomes itchy and painful when I walk. I am 14 years post-menopause and in otherwise excellent health. I would love to get off the expensive estradiol, but are there any long term, day-to-day suggestions from readers?

    My wife and I give a thumbs-up to coconut oil for vaginal dryness.

    My OBG recommended Replens, a vaginal lubricant. I use it every other day and it helps altho a bit expensive in the long run.

    Great ideas. Thanks for the information! This is certainly a problem for many of us women. I had endometriosis, and that makes it even worse.

    I tried, really tried going this route, but even with a really good lubricant, intercourse was still painful. As much as I hate having to use it, I still find that a small amount of Premarin 3 times a week works wonders. I still need a lubricant, but there’s no pain.

    I have found a product for vaginal dryness that works very well…”Yes” is the brand name. They offer a water based product, as well as an oil based one. The oil based works great! The product is produced in the UK, but is now sold via Amazon. They do offer a version that has an applicator, but otherwise, it is sold in a tube.
    No estrogen-based products for me, thank you!

    Valerie
    Greenville, SC

    Try YES OB (oil based) or YES WB (water based) organic plant-based personal lubricant. yesyesyes.org You can buy it on Amazon. Oil base is what I use, nothing else is as effective and gentle, plus all natural ingredients.

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