The Symptom Nobody Talks About: Vaginal Dryness During Perimenopause Is More Common Than You Think

There's a good chance you've never said these words out loud to anyone. Not to your best friend. Not to your partner. Maybe not even to your doctor.

Vaginal dryness during perimenopause is one of the most common symptoms of this transition, and it is also one of the least discussed. Up to 70% of perimenopausal and menopausal people experience it, according to research published in the journal Menopause. That means the majority of people going through this hormonal shift are dealing with the same thing. In silence.

The silence is the problem. When nobody talks about it, you assume you're alone. You assume something is wrong with you specifically, rather than understanding that your body is responding to a predictable hormonal change that has real, effective solutions.

So let's talk about it. Directly. Without shame. Because you deserve to feel comfortable in your own body, and that starts with understanding what's actually happening and knowing that there are things you can do about it, starting today.

What vaginal dryness actually feels like during perimenopause

If you've been mentally reducing this symptom to "just dryness," you're probably underselling what you're actually experiencing. Perimenopause vaginal dryness is broader, more disruptive, and more layered than the name suggests.

For many people, it starts with a persistent feeling of irritation or rawness. A low-level burning sensation that comes and goes throughout the day. Not dramatic enough to send you to the doctor, but noticeable enough to pull at your attention. You might feel it when you walk, when you sit for too long, when certain fabrics press against sensitive tissue.

Itching is common, too. An unexplained itch that doesn't respond to the usual remedies because it isn't caused by infection. It's caused by tissue that is thinner and more easily irritated than it used to be.

Then there's the impact on intimacy. Sex may have become uncomfortable, or outright painful. Even with arousal, your body may not produce the lubrication it once did. Penetration might feel tight, or create a friction that ranges from unpleasant to genuinely painful. Over time, this can quietly erode your desire to initiate intimacy at all. Not because you've lost interest in connection, but because your body has started associating it with discomfort.

Some people notice changes in discharge. Less of it, or a different consistency. The pH of your vaginal environment may shift, which can lead to a subtle change in odor. You might find yourself getting urinary tract infections more often, or feeling a vague urgency to urinate that wasn't there before.

Here's what matters: this is not just a bedroom issue. Vaginal dryness during perimenopause affects your daily physical comfort, your confidence, your intimate relationships, and your sense of yourself in your own body. And it tends to be progressive, meaning it doesn't typically resolve on its own without some form of intervention.

Why this is happening in your body

Your vaginal tissue has estrogen receptors throughout it. That means estrogen plays a direct, hands-on role in keeping this tissue healthy, thick, elastic, and moist. When estrogen levels begin to fluctuate and decline during perimenopause, the tissue starts to change.

Here's what happens at the biological level. Estrogen supports the production of glycogen in your vaginal lining. Glycogen feeds the lactobacilli bacteria that maintain your vaginal pH in its healthy acidic range (typically between 3.8 and 4.5). When estrogen drops, glycogen production decreases, the beneficial bacteria have less to work with, and your pH rises. A higher pH makes you more vulnerable to infections, bacterial imbalance, and irritation.

Estrogen also maintains the thickness of the vaginal walls. With less estrogen, the tissue becomes thinner, sometimes significantly so. Thinner tissue is more fragile. It's more easily irritated by friction, more prone to small tears, and slower to heal. The medical term for this is vaginal atrophy, though the updated terminology now used by many clinicians is genitourinary syndrome of menopause, or GSM.

Blood flow to the pelvic region decreases as estrogen declines. That reduced blood flow affects your body's ability to produce natural lubrication, especially during arousal. It also means the tissue receives fewer nutrients and less oxygen, which contributes to the thinning and fragility.

The elasticity of the tissue changes too. The vaginal walls lose some of their stretch and resilience. This can make penetration more difficult and can contribute to the tightness and discomfort many people describe.

One important thing to understand: these changes are progressive without intervention. Unlike hot flashes, which often improve over time, vaginal dryness tends to worsen as estrogen levels continue to decline through perimenopause and into menopause. The earlier you address it, the easier it is to maintain the health and comfort of this tissue. Waiting doesn't help, and there is no reason to wait.

What you can do about it, starting today

There are effective, evidence-backed strategies for managing perimenopause vaginal dryness. Some you can start this afternoon. Others require a conversation with your healthcare provider. Here are seven approaches worth knowing about.

1. Use a vaginal moisturizer regularly, not just during intimacy. Vaginal moisturizers like Replens or hyaluronic acid-based formulas are designed to be used several times per week to maintain ongoing hydration in the tissue. Think of them the way you'd think of moisturizing your face. You don't wait until your skin is cracking. You maintain it. Apply them consistently, and over a few weeks, most people notice a real improvement in daily comfort.

2. Choose the right lubricant for intimacy. Lubricant and moisturizer are different tools. Lubricant is for reducing friction during sexual activity. Look for water-based or silicone-based options. Avoid products containing glycerin, which can contribute to yeast infections, and skip anything with parabens or fragrances. Silicone-based lubricants tend to last longer and don't dry out as quickly, which many people find more helpful during perimenopause. Oil-based options work well for some, but they're not compatible with latex condoms.

3. Maintain regular sexual activity. This one might feel counterintuitive if intimacy has become uncomfortable. But regular sexual activity, whether with a partner or solo, increases blood flow to the vaginal tissue. That improved circulation supports natural lubrication and helps maintain elasticity. Combined with a good moisturizer and lubricant, this can meaningfully slow the progression of tissue changes.

4. Talk to your doctor about vaginal estrogen. Low-dose vaginal estrogen is considered the gold standard treatment for moderate to severe vaginal dryness during perimenopause. It comes in several forms: a cream, a ring, a tablet, or a suppository. The critical thing to know is that vaginal estrogen delivers estrogen directly to the tissue that needs it, with very low systemic absorption. That means the amount that enters your bloodstream is minimal. Research published in JAMA has shown that local vaginal estrogen does not carry the same risk profile as systemic hormone therapy. Many people who aren't candidates for systemic HRT can still safely use vaginal estrogen.

5. Try hyaluronic acid vaginal suppositories. Hyaluronic acid is a powerful moisture-binding molecule. Vaginal suppositories containing hyaluronic acid can help restore hydration to the tissue from the inside. Some studies have shown them to be comparable to low-dose estrogen for mild to moderate dryness. They're available over the counter and can be a good option if you want to start with a non-hormonal approach.

6. Stay well hydrated. Overall hydration supports the health of all mucous membranes in your body, including vaginal tissue. This isn't a standalone solution, but chronic dehydration can absolutely make dryness worse. Aim for consistent water intake throughout the day.

7. Eliminate irritants from your routine. Scented soaps, bubble baths, douches, fragranced laundry detergent, and scented panty liners can all irritate tissue that is already more sensitive than it used to be. Switch to fragrance-free, gentle products. Wear cotton underwear. Let your body's environment do its own work without chemical interference.

Why movement matters

You might not immediately connect exercise with vaginal health, but the link is real and worth understanding.

Physical activity increases blood flow throughout your entire body, including the pelvic region. That improved circulation delivers more oxygen and nutrients to vaginal tissue, supporting its ability to maintain moisture and elasticity. Regular movement also helps stabilize the hormonal fluctuations of perimenopause, which can indirectly ease the severity of GSM symptoms.

Pelvic floor exercises deserve specific attention here. Your pelvic floor muscles support your vaginal walls, bladder, and uterus. Strengthening them through Kegel exercises or structured pelvic floor training improves blood flow to the area, enhances sensation during intimacy, and supports urinary health. Even five minutes of focused pelvic floor work per day can produce noticeable results within a few weeks.

Yoga and other practices that include hip-opening and pelvic-focused movements can also be valuable. They combine the blood-flow benefits of movement with relaxation and body awareness, which supports your overall relationship with your physical self during a time when that relationship might feel strained.

PeriPlan's day-type system can help you find the right intensity of movement for any given day. On days when your body feels strong, a full strength-training session or brisk walk benefits your circulation and hormone balance. On days when energy is low or discomfort is higher, gentler movement like yoga or pelvic floor exercises keeps you connected to your body without pushing past what feels good.

Track it to understand it

Vaginal dryness can feel like a constant, unchanging problem. But when you start tracking it, patterns often emerge that give you useful information.

Try noting the severity of your symptoms each day for three to four weeks. Rate your daily comfort on a simple scale. Note what products you used, whether you were intimate, what you ate or drank, and where you are in your cycle if you're still having periods. You might discover that dryness worsens at specific points in your cycle, when estrogen is at its lowest. You might notice that certain foods, medications, or stress levels affect your comfort level.

This data becomes especially powerful when you're trying interventions. If you start using a vaginal moisturizer, tracking helps you see whether it's actually making a difference over time, rather than relying on vague impressions.

PeriPlan's daily check-in makes this kind of tracking quick and consistent. When you log your symptoms alongside your cycle data and other symptoms, you can start to see how vaginal dryness connects to the bigger picture of your perimenopause experience. That insight helps you make better decisions about what to try, what's working, and what to bring to your doctor.

When to talk to your doctor

You deserve to feel comfortable in your own body. Not just comfortable enough to get through the day, but genuinely at ease. Vaginal dryness during perimenopause is incredibly common, it is well understood, and it is treatable. You are not broken. Your body is navigating a hormonal shift, and there are real tools available to support it.

Whether you start with a moisturizer, a conversation with your doctor, or simply the recognition that what you're experiencing has a name and a solution, you're already taking a step forward. You don't have to tolerate this in silence.

This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before making changes to your health routine, starting supplements, or beginning hormone therapy.