Best Cream for Vaginal Dryness UK: The Complete, Honest Guide (2025/2026)

The best cream for vaginal dryness in the UK depends on the cause. For hormone-related dryness after menopause, low-dose vaginal oestrogen (including Gina for eligible women) is often the most effective option. For hormone-free relief, Replens MD and Vagisan MoistCream are the two most trusted, widely recommended moisturisers. For immediate relief during intercourse, a water-based lubricant like Knect (formerly KY Jelly) does the job. But there's a lot more nuance to it than that, and getting it wrong can make things worse. This guide walks you through everything.

At a Glance: Best Creams for Vaginal Dryness (UK)

1. Daily dryness (not just intercourse): vaginal moisturiser every 2–3 days (Replens / hyaluronic acid / Vagisan)
2. Dryness + external soreness: cream that can be used externally too (Vagisan, V-san external)
3. Pain during intercourse: water-based or silicone-based lubricant (avoid warming/tingling)
4. Post-menopause + ongoing symptoms: consider low-dose vaginal oestrogen for eligible women (pharmacist/GP guidance)

What Is Vaginal Dryness, and Why Does It Happen?

Vaginal dryness sounds simple, but it's actually a sign that your vaginal tissue has lost moisture, elasticity, or both. The medical term is Genitourinary Syndrome of Menopause (GSM) when it's linked to hormonal changes, though the condition affects women of all ages, not just those going through menopause.

Here's what's happening underneath: the lining of the vagina is kept moist and supple by oestrogen. When oestrogen drops, for any reason, the tissue thins, loses natural lubrication, and becomes more easily irritated. Left untreated, it doesn't go away on its own and typically gets worse over time.

What are the main causes of Vaginal Dryness?

The most common triggers in the UK include:

Natural Menopause is the most frequent driver. As ovarian oestrogen production stops permanently, the vaginal wall thins and dryness becomes chronic. This typically affects women aged 45 to 60 and beyond.

Postpartum and breastfeeding cause a temporary oestrogen dip because prolactin (the hormone that drives milk production) suppresses oestrogen. Most new mothers experience some degree of dryness within the first 6 to 12 months after delivery.

Cancer Treatments, particularly chemotherapy, aromatase inhibitors used in breast cancer care, and pelvic radiotherapy, cause an abrupt hormonal depletion that results in severe mucosal drying. For these women, finding the right treatment is especially important and should involve specialist guidance.

Autoimmune Conditions like Sjogren's syndrome attack the body's moisture-producing glands throughout the body, causing the eyes, mouth, and genitals to all suffer. Women with co-morbidities like lupus or rheumatoid arthritis may also be affected.

Medication Side Effects are an under-discussed cause, particularly among younger women. SSRIs (antidepressants), antihistamines (taken for hay fever or allergies), and some hormonal contraceptives can all reduce mucosal secretions. If you're taking these regularly and experiencing dryness, the medication may be a contributing factor worth raising with your GP.

Why Does Vaginal Dryness Matter? (And Why You Shouldn't Ignore It)

This is one of those things that many women quietly put up with, partly out of embarrassment and partly because it doesn't feel "serious." But it matters, for several reasons.

It affects your quality of life directly. Pain during intercourse, a constant burning or itching sensation, and recurring discomfort during everyday activities like walking or sitting are real quality-of-life issues, not minor inconveniences.

It can lead to physical complications. Dry, thinned tissue tears more easily. This can cause micro-tears during intercourse, spotting, and a greater susceptibility to infections like bacterial vaginosis and thrush.

It's linked to bladder health. The same tissues that support vaginal health also support bladder function. Many women with GSM experience a frequent urge to urinate, discomfort passing urine, or recurrent urinary tract infections.

It's progressive without treatment. Unlike hot flushes, which tend to reduce over time, vaginal dryness from oestrogen loss typically worsens over the years if left untreated.

The good news: it's very treatable. And there are more good options available in the UK right now than ever before.

The Difference Between a Vaginal Moisturiser and a Lubricant

Moisturisers and lubricants are not the same thing, and using the wrong one won't help you properly. A moisturiser works on the tissue itself over time; a lubricant reduces friction in the moment.

Think of it like this: a moisturiser is like a skincare cream you apply regularly to repair and hydrate. A lubricant is like a quick-dry oil you use just before an activity. Both have their place, but they serve completely different purposes.

Vaginal moisturisers are applied regularly (every 2 to 3 days for most products) to restore moisture to the vaginal tissue at a deeper level. They don't just sit on the surface. They're bio-adhesive, meaning they cling to the mucosa and rehydrate it gradually. They're designed to address the underlying dryness, not just the friction.

Lubricants are applied immediately before or during intercourse. They reduce friction and prevent discomfort in the moment, but do nothing to change the health of the vaginal tissue over time. They are a short-term solution.

The ideal approach for most women with persistent dryness is to use both: a regular moisturiser to treat the tissue, and a lubricant during intercourse for immediate comfort.

Best Vaginal Moisturisers for Vaginal Dryness UK

1. Best for long-lasting internal moisture: Replens MD.
2. Best for internal + external soreness: Vagisan MoistCream.
3. Best hyaluronic acid option: Vagisil ProHydrate.

Replens MD: The Most Widely Used Option

Replens MD is the most clinically studied non-hormonal vaginal moisturiser available in the UK. It uses a bio-adhesive polycarbophil formula that attaches to the vaginal wall and releases moisture gradually over up to 72 hours.

How it works: You insert it using a pre-filled applicator (typically every 3 days, or as needed). The gel adheres to the vaginal lining, absorbs water from the surrounding tissues, and holds it at the mucosal surface, essentially acting as a slow-release moisture reservoir.

Key benefit: Some clinical studies suggest it can provide comparable symptom relief for some women, although responses vary. It doesn't contain hormones, making it suitable for women who can't or don't want to use HRT.

One thing to know: Some women notice a white or clumpy discharge after using Replens. This is completely normal. It's the gel shedding dead cells from the vaginal lining, which is actually part of the healing process. It can be managed by wearing a thin panty liner.

Price: £8.49 to £10.99 for a standard 6-applicator pack.

Pros:

• Long-acting (up to 72 hours per application)
• Hormone-free
• Supported by clinical studies
• Available over the counter
• Widely available online and in high street pharmacies

Cons:

• Can cause a temporary clumpy discharge (off-putting for some users)
• Single-use applicators mean more plastic waste
• Works gradually and is not for immediate relief

Vagisan MoistCream: The Best for External and Internal Use

Vagisan MoistCream is a lipid-enriched cream that works both internally and externally, making it particularly good for women with dryness and irritation of the vulva (the outer area) as well as the vaginal canal.

Unlike Replens, which is a gel applied internally, Vagisan has a cream texture that can be applied to the labia and surrounding skin as well. This makes it more versatile for women whose dryness extends to external soreness, itching, or irritation.

What's inside: It contains a blend of emollient lipids that mimic the skin's natural barrier function. It's free from hormones, parabens, and fragrances, which makes it a good choice for women with sensitive skin or those who react to certain preservatives. Thanks to the addition of lactic acid, the cream is set at a pH of 4.5, matching the natural vaginal environment.

Confirmed price: £14.49 for a 50g tube (on sale from £15.99).

Pros:

• Dual internal and external use
• Cream format makes it easier for some users to apply
• Paraben-free and fragrance-free
• Good for vulval dryness specifically
• No applicator required

Cons:

• Slightly higher price point than Replens
• Can feel greasy if over-applied externally
• Not as long-lasting as Replens MD between doses

Vagisil ProHydrate Internal Gel: For Women Who Want Hyaluronic Acid

Vagisil ProHydrate is a vaginal gel containing hyaluronic acid, which draws moisture deep into the vaginal tissue. It's particularly popular with women looking for a more skincare-aligned approach to intimate health.

Hyaluronic acid has become one of the most talked-about ingredients in facial skincare because of its ability to hold up to 1,000 times its own weight in water. The same principle applies when used vaginally. The gel pulls moisture into the deeper tissue layers rather than just sitting at the surface.

Dosing: It's typically used every 3 days, making it economical and convenient for regular use.

Confirmed price: £12.99 for a 6 x 5g pack (on sale from £13.99).

Pros:

• Hyaluronic acid draws moisture into tissues at a deeper level
• Works without hormones
• Easy-to-use single-dose applicators
• Good for sensitive users

Cons:

• Effects build gradually, so patience is required
• Applicators are single-use only

Dr Wolff's V-san Moisturising Cream: A Hormone-Free Maintenance Option

Dr Wolff's V-san Moisturising Cream is a daily-use, hormone-free cream focused more on ongoing maintenance and external skin protection than intensive internal rehydration.

It's particularly suited to women who experience soreness and irritation in the external genital area, or who want a gentle everyday product to prevent dryness from worsening. It forms a breathable, water-repellent protective film over the skin without blocking moisture. A reviewer noted it helped where nothing else had worked for her external genital irritation.

Confirmed price: £13.10 for a Dr Wolff’s V-San Moisturising Cream 50g tube (on sale from £14.99).

Pros:

• Protective and soothing for external genital skin
• Suitable for daily use
• Hormone-free
• Can be used during menstruation

Cons:

• Primarily for external use rather than internal rehydration
• Not strong enough for severe internal vaginal atrophy on its own
• Less clinical evidence than Replens or Vagisil ProHydrate for internal use

Hyalofemme: The High-Concentration Hyaluronic Acid Option

Hyalofemme uses Hydeal-D, a proprietary derivative of hyaluronic acid, and is applied every 3 days. It's one of the more advanced formulas available, but it tends to be variable in price and availability.

It's particularly valued for its ability to improve vaginal moisture long-term without any hormonal ingredients. Some women use it when looking for a hyaluronic acid-driven approach to internal dryness.

Price: Variable. Some versions require a prescription. Worth checking with your GP or pharmacist for current availability.

Vaginal Oestrogen for Vaginal Dryness (UK): When to Consider It

For women whose dryness is caused directly by low oestrogen, particularly post-menopausal women, non-hormonal moisturisers provide symptomatic relief but don't fix the underlying cause. Think of it this way: moisturisers hydrate the tissue, but if the oestrogen deficit continues, the tissue keeps thinning. Local vaginal oestrogen can help reverse or significantly improve those tissue changes over time.

What Is Gina, and Is It Available Over the Counter in the UK?

Yes. Gina (10mcg estradiol vaginal tablets) became the first vaginal oestrogen treatment available without a prescription in the UK. It's available over the counter for post-menopausal women over 50 who haven't had a period in at least a year.

This was a significant shift in UK pharmacy law. Previously, all vaginal oestrogen required a GP prescription. Gina changed that, making it accessible directly from pharmacies, including registered UK online pharmacies, which require a short eligibility questionnaire to confirm suitability.

How it works: A small tablet is inserted into the vagina using a disposable applicator, where it dissolves and releases a tiny, localised dose of estradiol. For many women, the low-dose local approach is considered lower risk than systemic HRT, but suitability still depends on personal history.

What it treats at the root: Over a 12-week treatment period, Gina works to thicken the vaginal walls, restore the natural vaginal pH to its healthy range (around 4.5), and increase natural secretions. It doesn't just manage symptoms. It can help reverse vaginal atrophy changes over time.

Price: Approximately £25 to £30 for an initial pack. Considerably cheaper than a private consultation fee if bought over the counter.

Pros:

• Targets the underlying cause in many cases of hormone-related dryness
• Very low systemic absorption
• Widely recommended in UK menopause care for GSM
• No prescription needed for eligible women
• Long-lasting results with consistent use

Cons:

• Not suitable for women currently menstruating
• Takes up to 12 weeks to see full results
• Some women prefer hormone-free options as a matter of personal preference

Pharmacists will check suitability first, and some people (especially with a history of hormone-sensitive cancers) need specialist advice before using any vaginal oestrogen.

Best Lubricants for Vaginal Dryness During Intercourse (UK)

Knect (Formerly KY Jelly) and Water-Based Options

Knect, the product formerly known as KY Jelly, is a water-based lubricant that provides immediate friction reduction during intercourse. It's safe to use with condoms and is widely available across UK pharmacies.

Water-based lubricants are the standard first choice because they're compatible with latex condoms, easy to wash off, and pH-neutral.

One thing to note: Some water-based lubricants contain glycerin, which can occasionally cause irritation or a slightly sticky feel for women with sensitive or severely atrophied tissue. If you find water-based options irritating, a silicone-based lubricant may work better. Silicone lubricants last longer and don't evaporate, though they need to be washed off with soap and water afterwards and cannot be used with silicone toys. Silicone lube lasts longer but may not be compatible with silicone toys.

What to avoid: "Warming" or "tingling" lubricants that contain capsicum (chilli extract) or menthol. On healthy tissue, these produce a pleasant sensation. On atrophied or sensitive vaginal skin, they can cause real pain.

The Layered Relief Protocol: A Smarter Approach to Vaginal Dryness

Think of vaginal dryness not just as "needing more water" but as a breakdown of the intimate skin barrier, very similar to how dry, sensitive facial skin is actually a barrier repair problem. This reframe makes it easier to understand why a single product rarely gives full results, and why a layered approach works best.

Phase 1: Cleanse Without Stripping. Switch from scented soap to a pH-balanced, soap-free emollient wash like Dermol 500 or Hydromol. Use it only on the external vulval area. Never insert anything inside to "clean" the vagina. It is self-cleaning, and doing so disrupts the protective Lactobacillus bacteria.

Phase 2: Deep Rehydration. Apply a vaginal moisturiser (Replens MD, Vagisil ProHydrate, or Vagisan) regularly, not just before intercourse. Think of this as your "treatment" layer, the one that's actually improving tissue health over time.

Phase 3: Microbiome Support. Oral probiotics specifically formulated for intimate health, such as CanesBiotics, support the gut-vagina axis. Healthy gut bacteria help maintain the vaginal Lactobacillus population, which produces the lactic acid that keeps the vaginal pH naturally acidic and resistant to infection.

Phase 4: Immediate Relief During Intercourse. Use a water-based lubricant like Knect alongside (not instead of) your regular moisturiser during intercourse.

The Dos and Don'ts of Treating Vaginal Dryness in the UK

What You Should Do

Do choose iso-osmotic products. Look for this on the label. It means the product's salt concentration matches your body's own tissues. Products with very high osmolality can actually draw moisture out of cells and cause more irritation. This is a clinically significant quality indicator.

Do apply at night. Whether it's a moisturiser or a hormonal tablet, nighttime application means gravity works in your favour, and you're less likely to notice any initial discharge.

Do sleep without underwear when possible. Allowing the vulva to breathe at night reduces heat and moisture build-up, particularly when using emollient creams.

Do pelvic floor exercises regularly. Kegel exercises increase blood flow to the pelvic tissues, which supports vaginal health and tissue suppleness over time.

Do tell your nurse before a smear test. It allows them to use a smaller speculum and extra lubricant, something that makes a real difference to your comfort.

Do give treatments time. Non-hormonal moisturisers take up to 4 weeks to show significant results. Hormonal treatments like Gina take up to 12 weeks for full tissue restoration. Don't stop because you don't feel better after a week.

Do consider the HRT PPC if you're on prescription oestrogen. At £19.80 per year, it's one of the best-value financial decisions available to post-menopausal women in England.

What You Should Not Do

Don't use body lotions, petroleum jelly (Vaseline), or baby oil internally. These products are not formulated for mucosal tissue. They can trap bacteria against the vaginal wall, are very difficult to wash away, and significantly increase infection risk.

Don't ignore unusual bleeding. Any vaginal bleeding after menopause, or unexplained bleeding between periods, must be investigated by a GP to rule out endometrial or cervical causes. Don't assume it's just dryness. Post-menopausal bleeding should always be assessed by a clinician, even if dryness is present.

Don't use warming or tingling lubricants. On atrophied tissue, capsicum or menthol-based "sensation" products can cause intense pain. They're designed for healthy, resilient tissue and are simply not suitable if you have GSM.

Don't use baby wipes or "feminine hygiene wipes" on the vulva. Most contain alcohol, preservatives, and fragrances that irritate sensitive skin and alter the natural pH balance.

Don't stop treatment too early. This is possibly the most common mistake. Both hormonal and non-hormonal treatments need consistent, sustained use to work properly. Stopping as soon as you feel slightly better will mean the tissue returns to its previous state.

Don't use yoni pearls, vaginal steaming, or unregulated "natural" remedies advertised on social media. These carry a genuine risk of infection, chemical burns, and disruption of the vaginal microbiome.

When to see a GP about vaginal dryness?

1. Any bleeding after menopause
2. Pain that persists or worsens
3. Recurrent UTIs / thrush / BV
4. Symptoms not improving after 8–12 weeks of regular moisturiser use
5. New symptoms after starting a medication
6. If you’ve had breast cancer or another hormone-sensitive condition, check with your GP or specialist before using vaginal oestrogen.

Why Consistency Matters More Than Quantity in Vaginal Dryness Treatment

Treating vaginal dryness works more like skincare than most people realise.

Using a vaginal moisturiser only when symptoms flare up will almost always give weaker results than using a simple, hormone-free moisturiser every two to three days as routine maintenance.

The key principle:
Regular maintenance protects tissue before it degrades. Occasional use only reacts to symptoms after they’ve worsened.

With genitourinary syndrome of menopause (GSM) or vaginal atrophy, the tissue is thinner and more vulnerable. Consistency helps stabilise moisture levels, support pH balance, and reduce irritation over time.

Do You Need More Than One Product for Vaginal Dryness?

Often, yes, because different layers of the problem need different support.

A structured routine might include:

• External barrier protection (for vulval dryness)
• Internal rehydration every 2–3 days with a vaginal moisturiser
• Microbiome support to help maintain Lactobacillus balance
• Lubricant during intercourse to reduce friction

Each step targets a separate mechanism:

• The skin barrier needs to be protected externally.
• The vaginal mucosa needs hydration internally.
• The vaginal microbiome benefits from stability.
• Friction needs to be reduced in the moment.

This layered approach is not excessive; it’s targeted care.

How Long Does a Vaginal Dryness Routine Take?

Once established, a routine takes less than five minutes every few days. The goal is low-effort, long-term maintenance rather than constant symptom chasing.

Consistency, not intensity, is what improves comfort over time.

Why Warming Lubricants Can Make Vaginal Dryness Worse

Warming or “tingling” lubricants are one of the most overlooked causes of worsening vaginal irritation, especially in women with genitourinary syndrome of menopause (GSM) or vaginal atrophy.

These products are often marketed as “sensation-enhancing” and typically contain ingredients such as:

• Capsaicin (derived from chilli peppers)
• Menthol
• Peppermint or other cooling agents

On healthy vaginal tissue, these ingredients can create a mild warming or cooling sensation. However, on thinned, oestrogen-deficient, or sensitive vaginal tissue, they can trigger significant burning, stinging, and inflammation. In women with postmenopausal vaginal dryness, this discomfort can last for hours.

If you are already dealing with vaginal dryness, micro-tears, or atrophic vaginitis, warming lubricants can aggravate symptoms rather than relieve them.

Quick rule:

If a lubricant promises heat, tingling, cooling, or enhanced sensation, it is not suitable for dry or atrophic tissue.

Why Antibacterial Intimate Washes Disrupt Vaginal Health

Another common mistake is using “antibacterial,” “freshening,” or “deodorising” intimate washes.

The issue is not simply that these products are harsh. The real problem is that they disrupt the vaginal microbiome.

Healthy vaginal tissue is protected by Lactobacillus bacteria, which:

• Maintain a natural acidic pH of around 4.5
• Prevent overgrowth of harmful bacteria
• Reduce the risk of infections like thrush (candida) and bacterial vaginosis (BV)

Antibacterial washes do not selectively remove harmful bacteria. They can reduce protective Lactobacillus levels as well. Once this balance is disturbed, the vaginal pH rises, making infections more likely.

These infections are frequently mistaken for worsening vaginal dryness or atrophic vaginitis, leading to a cycle of irritation and repeated treatment.

What to Avoid If You Have Vaginal Dryness

If you are managing postmenopausal vaginal dryness, GSM, or irritation, avoid:

• Warming or tingling lubricants
• Menthol or capsaicin-containing products
• Antibacterial intimate washes
• Internal “freshening” products
• Products that promise deodorising or cleansing inside the vagina

The vagina is a self-regulating environment. It does not need internal cleaning.

What Actually Helps in Vaginal Dryness

For vaginal dryness and irritation:

• Use a hormone-free vaginal moisturiser regularly (every 2–3 days)
• Choose iso-osmotic, pH-balanced lubricants for intercourse
• Clean only the external vulval area with plain water or a soap-free emollient
• Avoid anything that adds artificial sensation

When tissue is already vulnerable, simplicity is protective. Barrier support and consistent moisturising are far more effective than products designed to “enhance” or “freshen.”

How Much Does Treatment Cost in the UK? (2025/2026 Price Guide)

Prices below are confirmed live from UK Meds Online, where applicable.

Final Words

Vaginal dryness is one of those conditions that far too many women manage alone, in silence, for far too long. It's common, it's real, and it's treatable, often very effectively, without a GP appointment or prescription.

Whether you choose a non-hormonal moisturiser like Replens MD or Vagisan MoistCream from UK Meds Online, a hyaluronic acid gel like Vagisil ProHydrate, or you're eligible for Gina as an over-the-counter hormonal option, there's a well-evidenced product that can genuinely improve your comfort and quality of life.

The most important thing is to start and then stick with it. These treatments take time, but they work.

This article is written for informational purposes and does not replace personalised medical advice. If you have any concerns about your symptoms, particularly unusual bleeding or complex medical conditions, please speak to your GP or a qualified menopause specialist before starting any new treatment.

Relevant guidelines: British Menopause Society (BMS), NICE Clinical Guideline NG23 (Menopause: diagnosis and management), NHS.

FAQs

Q: What does vaginal dryness actually feel like in the early stages?

In the early stages, it often feels like a mild soreness, itching, or friction during intercourse, not dramatic, but persistent. Many women first notice it during intercourse, when what used to feel comfortable suddenly feels rough or uncomfortable. As it progresses, the dryness can become present all the time: a low-grade itch, a feeling of tightness, or a burning sensation that doesn't go away. It's easy to dismiss in the early stages as a one-off irritation, which is why many women don't seek help until the symptoms are more advanced.

Q: Why is my vagina so dry and sore even though I'm still having periods?

Dryness before menopause is more common than most people realise, and periods don't mean your oestrogen levels are stable. Perimenopause, the transition period before your last period, can last anywhere from 2 to 10 years. During this time, oestrogen fluctuates wildly rather than declining steadily. These fluctuations can cause dryness even when you're still menstruating regularly. Stress (which elevates cortisol and suppresses the hormones), medications like SSRIs or antihistamines, and certain contraceptives can also cause dryness at any age.

Q: Can vaginal dryness cause a constant urge to urinate?

Yes. This is one of the lesser-known but very common symptoms of GSM, and it's frequently overlooked. The tissues of the vagina and the urethra share the same oestrogen receptors. When oestrogen drops, both are affected. This can lead to urgency (a sudden need to urinate), frequency (needing to go more often than usual), and discomfort passing urine, without any actual infection being present. If you're experiencing these bladder symptoms alongside dryness, both local hormonal and non-hormonal treatments may help, but it's worth mentioning to your GP too.

Q: Is it normal to have light bleeding or spotting after intercourse when I feel dry?

Light spotting after intercourse, when you're very dry, can happen, but any unexplained bleeding should always be checked by a GP. When the vaginal tissue is very thin and dry, the friction of intercourse can cause tiny surface tears, resulting in a small amount of blood. This is more common in post-menopausal women. However, bleeding after menopause (even a small amount) should never be assumed to be just dryness without ruling out other causes. If it happens even once, book an appointment.

Q: Does bleeding after menopause always need checking?

Yes. Any vaginal bleeding after menopause must be assessed by a GP. Under UK NHS guidance, post-menopausal bleeding (PMB) is treated as a possible sign of endometrial cancer until proven otherwise. Women with PMB are typically referred through the urgent two-week pathway for investigation.

Around 1 in 10 women with post-menopausal bleeding (who are not on HRT) are diagnosed with endometrial cancer. Most cases turn out to be benign causes such as vaginal atrophy, but this cannot be self-diagnosed at home.

Q: How do I tell if I have a yeast infection or just vaginal dryness?

The key difference is discharge. Thrush typically causes a thick, white, cottage-cheese-like discharge; dryness doesn't. Both conditions can cause itching and soreness, which makes them easy to confuse. A self-test kit like Canestest (widely available in UK pharmacies) can help distinguish between bacterial vaginosis, thrush, and dryness by testing the vaginal pH. A pH above 4.5 suggests BV or other infection; a normal pH alongside symptoms points more towards dryness. If you're unsure, a pharmacist or GP can help.

Q: Can stress and anxiety make my vagina feel dry?

Yes. Psychological stress has a direct physiological effect on vaginal lubrication. Stress triggers cortisol release, which suppresses hormone production and reduces blood flow to the pelvic region. Anxiety can also affect arousal, meaning that even when you want to be intimate, the body doesn't respond in the usual way. This can create a cycle where discomfort leads to anxiety about intercourse, which leads to more dryness. It's not "in your head." It's a genuine hormonal and vascular response.

Q: Does being dehydrated affect how much natural lubrication I produce?

It can. Systemic hydration affects mucosal secretions throughout the body, including the vagina. While drinking more water won't cure hormone-related dryness, dehydration makes mild dryness noticeably worse. Most adult women need at least 1.5 to 2 litres of water daily. Excessive caffeine and alcohol intake can both contribute to dehydration and worsen vaginal symptoms.

Q: Why does my vagina feel like it's burning after I use scented soap?

Scented soaps typically have a pH of 9.0 to 10.0, which is catastrophically alkaline for vaginal tissue that needs a pH of around 4.5. This mismatch strips the natural acid mantle of the vulva, disrupts the Lactobacillus bacteria that protect the vagina, and irritates already-sensitive tissue. If you're using anything scented, foamy, or antibacterial in that area, stop immediately. The healthiest approach is to wash the external vulva only with plain water, or with a soap-free emollient like Dermol 500 or Hydromol.

Q: Can a lack of foreplay be the only reason for vaginal dryness during intercourse?

Not if it's persistent. Situational dryness during intercourse is different from chronic vaginal dryness. Arousal-related lubrication requires time and stimulation to build up. If you find you're generally well-lubricated outside of intercourse but dry during intercourse, extended foreplay and attention to arousal may help. However, if dryness is present all the time, during everyday activities and not just intercourse, then the cause is likely hormonal or tissue-related and needs to be treated accordingly.

Q: Is vaginal dryness a permanent symptom of menopause, or does it go away?

Unlike hot flushes, which tend to ease over time, vaginal dryness caused by GSM is progressive and does not resolve on its own. This is one of the most important things to understand. Without treatment, the vaginal tissue continues to thin and lose moisture as oestrogen remains absent. Treatment, whether hormonal or non-hormonal, can reverse or stabilise the condition significantly, but it typically needs to be continued long-term.

Q: Which is the best hormone-free vaginal moisturiser in the UK?

Replens MD is the most well-evidenced hormone-free vaginal moisturiser in the UK. Vagisan MoistCream is the best choice if you also need relief for external vulval dryness. For women interested in hyaluronic acid formulas, Vagisil ProHydrate Internal Gel (£12.99 at UK Meds Online) is an excellent alternative.

Q: Can I use oestrogen tablets like Gina if I'm already on HRT patches?

This is a question worth discussing with your prescriber, but the short answer is: yes, many women use both. Systemic HRT (patches, tablets, gels) delivers oestrogen throughout the body. However, some women find that their vaginal symptoms don't fully resolve with systemic HRT alone, and a low-dose local vaginal oestrogen like Gina can be used alongside it. The amount of oestrogen absorbed from Gina is so small that it doesn't significantly add to the systemic dose, but your GP or menopause specialist should confirm this based on your individual situation.

Q: Is it safe to use coconut oil internally for dryness if I use condoms?

No. Oil-based products, including coconut oil, degrade latex condoms, significantly increasing the risk of breakage. This is a very common mistake. Coconut oil is safe to use externally for vulval dryness if you're not using latex condoms, but it shouldn't be used internally with a condom in place. It also has no clinical evidence to support its use as a vaginal moisturiser, and there's a concern that it may alter the vaginal microbiome over time. For internal use with condoms, always choose water-based options.

Q: How long does it take for Gina tablets to start working for dryness?

Most women notice some improvement within 4 to 6 weeks, but the full benefit of tissue restoration takes around 12 weeks. Initial symptoms like immediate soreness can ease relatively quickly as the tissue begins to absorb the oestrogen, but the structural improvements, including thicker walls, better pH balance, and improved secretions, take longer to fully develop. Patience is essential, and Gina should be used consistently as directed rather than stopping as soon as you feel better.

Q: Can I buy oestrogen cream over the counter at a UK pharmacy?

Gina (10mcg estradiol tablets) is now available without a prescription in the UK for women over 50 who are post-menopausal. Other vaginal oestrogen products, such as Vagifem and Ovestin cream, still require a GP prescription. Gina can be purchased from registered UK online pharmacies, which require a short eligibility questionnaire to confirm suitability.

Q: Which vaginal cream is best for someone with very sensitive skin?

Look for products that are paraben-free, glycerin-free, and fragrance-free. YES VM Vaginal Moisturiser is a particularly good example for very sensitive users. Vagisan MoistCream is also fragrance and paraben-free. If you react to many products, patch testing on a small area of skin before internal use is sensible. Avoid anything containing propylene glycol, benzyl alcohol, or chlorhexidine, as these can cause reactions in sensitive tissue.

Q: Are there any vaginal dryness treatments safe during pregnancy?

Yes. Plain emollients and simple moisturisers like Hydromol or Aquamax can be used externally during pregnancy. For internal application during pregnancy, a clean finger is recommended over an applicator to avoid any pressure on the cervix. Hormonal treatments like Gina are not appropriate during pregnancy. Always confirm any internal product use with your midwife or GP during pregnancy.

Q: Can I use Vagisil Medicated Creme for long-term vaginal dryness?

No. Vagisil Medicated Creme is designed for temporary, acute itch relief, not for ongoing dryness treatment. This is an important distinction. It contains benzocaine (a local anaesthetic) and is meant to quickly numb surface itching for short-term comfort. It doesn't rehydrate tissue, doesn't treat the underlying cause, and is not intended for regular long-term use. Using it repeatedly could mask symptoms that need proper treatment.

Q: How do I apply vaginal cream internally without making a mess?

Apply it at night just before bed. That's the single most effective tip for avoiding mess. Gravity is your friend when you're lying down, and you won't be moving around. Wearing a thin panty liner to bed when using a gel or cream is the most practical solution most women find. If using a pre-filled applicator like those with Replens, insert it just before lying down, then relax. Some women find it helpful to warm the applicator slightly in their hands first if the gel feels uncomfortably cold.

Q: Can I swim in a chlorinated pool if I have vaginal irritation?

Chlorinated water is an irritant for atrophied or sensitive vaginal tissue, so it can worsen symptoms. Chlorine strips the protective acid mantle of the vulva and can cause stinging or increased dryness. If you swim regularly and have vaginal irritation, rinse the area thoroughly with plain water immediately after swimming and apply a barrier emollient to the external skin. Avoiding tight, wet swimsuits for extended periods also helps.

Q: What type of underwear should I wear to help with vaginal itching?

100% cotton, loose-fitting underwear is the right choice. Synthetic fabrics trap heat and moisture, creating an environment that worsens both dryness and the risk of yeast infections. Lace and tight elastic can cause direct friction. Many women with severe symptoms find that sleeping without underwear at night gives significant relief.

Q: Do I need to wash my vaginal applicator with soap and water after every use?

Yes. Single-use applicators (like those with Replens) should be discarded after each use. Reusable applicators should be washed with warm water and mild soap and dried thoroughly. Never use antiseptic products or antibacterial soap on applicators that will be inserted internally, as residue can irritate mucosal tissue.

Q: Can I use a vaginal moisturiser if I have a Mirena coil or an IUD?

Yes. Vaginal moisturisers and lubricants are completely compatible with IUDs and coils. The products are applied to the vaginal canal and do not affect the IUD placement or function. Water-based and hyaluronic acid-based products are particularly safe with any contraceptive device.

Q: Does smoking make vaginal dryness worse by affecting blood flow?

Yes, significantly so. Smoking impairs circulation throughout the body, including to the pelvic region. Poor blood flow to vaginal tissue reduces the natural moisture and repair mechanisms. Smoking also accelerates the timing of menopause by an average of 1 to 2 years, meaning earlier onset of GSM. If you smoke and experience vaginal dryness, stopping smoking is one of the most impactful things you can do for long-term vaginal health.

Q: What foods or supplements can help increase natural vaginal moisture?

Omega-3 fatty acids (found in oily fish, flaxseed, and walnuts) and sea buckthorn oil have the strongest evidence for supporting mucosal health. Sea buckthorn oil, available in capsule form, has been studied specifically for vaginal dryness and shown modest but genuine improvements in some clinical trials. Keeping hydrated, reducing alcohol and caffeine, and maintaining a diet rich in phytoestrogens (soy, chickpeas, lentils, flaxseeds) may also support oestrogen activity naturally, though these dietary sources are mild compared to medical treatments.

Q: How do I talk to my GP about vaginal dryness without being embarrassed?

The simplest approach: write it down before you go. Many women find it easier to say "I've written down what I want to discuss" and hand over a note at the start of the consultation, rather than trying to say the words aloud. You can simply say: "I'm experiencing symptoms of GSM, vaginal dryness, discomfort during intercourse, and I'd like to discuss my options." GPs hear this regularly, and it's a recognised, treatable medical condition. You have every right to a proper discussion about it.

Q: I've had a hysterectomy; why is my vagina suddenly so dry?

If your hysterectomy involved the removal of the ovaries (bilateral oophorectomy), you will have entered surgical menopause immediately, regardless of your age. This is a sudden, complete drop in oestrogen that can cause more acute GSM symptoms than gradual natural menopause. If your ovaries were retained, the transition may be more gradual. Either way, this is a very valid reason to speak to a menopause specialist about both systemic and local hormonal options, as surgical menopause often requires more active management than natural menopause.

Q: Can taking antihistamines every day for hay fever cause vaginal dryness?

Yes. This is more common than most people realise, particularly in younger women. Antihistamines work by blocking histamine receptors throughout the body, including those in the mucous membranes. The result is reduced secretions in the nose (the intended effect), but also in the eyes and vaginal tissues. If you take antihistamines daily for allergies and experience dryness, this may well be connected. Non-hormonal vaginal moisturisers are the safest option here, and it may be worth asking your GP whether the antihistamine can be switched or reduced.

Q: Is the "Mona Lisa Touch" laser treatment for dryness available on the NHS?

No. Fractional laser treatments like Mona Lisa Touch are primarily available privately in the UK, typically costing £1,000 to £3,000 for a course of treatment. The NHS does not currently fund this treatment routinely. While the evidence base is growing and some private menopause clinics offer it, NICE has not yet recommended it for routine NHS use. For most women, local oestrogen therapy produces comparable results at a fraction of the cost.

Q: Can I use E45 or Sudocrem on my labia to stop the itching?

E45 applied gently to the external vulval skin is generally safe as a barrier emollient, but Sudocrem is not recommended for vaginal use. Sudocrem contains zinc oxide, benzyl alcohol, and benzyl benzoate. The latter two are potential irritants on very sensitive mucosal skin. E45 is a simple emollient that can provide a barrier effect and mild moisture, but it's not formulated for vaginal use and won't address the underlying cause of dryness. A product designed for vulval use, like Vagisan externally or a soap-free emollient wash, is a better long-term choice.

Q: Why does it hurt so much when my nurse does a cervical smear test now?

Vaginal atrophy thins the vaginal wall, making the speculum insertion during a smear test significantly more uncomfortable than it would have been before. This is a well-recognised issue, and you are absolutely entitled to ask for accommodations. Tell the nurse or doctor before the procedure that you have vaginal dryness or atrophy. They can use a smaller-sized speculum and apply extra lubricant, which makes a significant difference. Some GPs may also suggest using Gina for a few weeks before a smear test to prepare the tissue.

Q: Are there "sperm-friendly" lubricants for dryness when trying for a baby?

Yes. If you're trying to conceive, it's important to use a lubricant that is iso-osmotic and sperm-friendly, as many standard lubricants can impair sperm motility. Products labelled "fertility-friendly" or "sperm-safe" are formulated to match the osmolality of the reproductive tract and not interfere with sperm. Conceive Plus and Pre-Seed are the two most established options in the UK market. Avoid standard lubricants and any product not specifically labelled as fertility-safe when trying to conceive.

Q: Can I use a vaginal moisturiser while I have a period?

Yes. There's no clinical reason you cannot use a vaginal moisturiser during menstruation. It won't interfere with your period in any way. Some women prefer to use external application only during their period for comfort and hygiene reasons, and that's perfectly fine.

Q: Why does my vaginal moisturiser cause a white, clumpy discharge?

This is the most common concern women raise about Replens MD, and it's completely normal and not a sign of infection. What you're seeing is the bio-adhesive gel pulling dead cells away from the vaginal walls as it works. This shedding is actually part of the healing process and indicates the moisturiser is doing its job. It can look similar to thrush discharge, which is why it causes alarm, but the key difference is that thrush typically causes itching and soreness alongside the discharge, while Replens-related discharge is usually symptom-free.

Q: Is it safe to use "yoni pearls" or vaginal steaming for dryness?

No. These are not safe, and neither the NHS nor any credible medical body recommends them. Yoni pearls are small herbal bags inserted into the vagina, and vaginal steaming involves exposing the vagina to herbal steam. Both practices disrupt the vaginal pH and microbiome, can cause burns (steaming), introduce infection risk (pearls), and there is zero clinical evidence that they help with dryness. These trends are largely driven by social media marketing, not medicine. The British Menopause Society and NHS strongly advise against them.

Q: How can I save money on my vaginal oestrogen prescriptions in the UK?

The most significant saving is the HRT Prescription Prepayment Certificate (PPC), which covers all your HRT prescriptions, including vaginal oestrogen, for just £19.80 per year. This is administered by the NHS Business Services Authority (NHSBSA) and can be applied for online. For context, a single NHS prescription costs £9.90 in England (as of 2025/2026). If you have two or more repeat prescriptions, the annual HRT PPC pays for itself immediately. Alternatively, buying Gina over the counter from a registered online pharmacy can sometimes be cheaper than obtaining it on prescription, particularly if you don't have a PPC.