Choosing a Vaginal Moisturiser for Perimenopause: What Works and Why
Vaginal dryness during perimenopause is common and treatable. Learn what to look for in a vaginal moisturiser, how they differ from lubricants, and when to consider medical options.
Why Vaginal Dryness Happens in Perimenopause
Falling oestrogen levels during perimenopause thin and dry the vaginal tissue, a process sometimes called the genitourinary syndrome of menopause (GSM). Unlike hot flashes, this symptom tends to worsen over time rather than improve, so it is worth addressing proactively rather than waiting. Vaginal moisturisers are a first-line, non-hormonal option that can significantly reduce dryness, irritation, and discomfort in daily life and during sex.
Moisturisers vs Lubricants: An Important Distinction
Vaginal moisturisers and lubricants serve different purposes. A moisturiser is used regularly (typically every two to three days) to maintain tissue hydration over time. It works similarly to a facial moisturiser, replenishing moisture in the vaginal mucosa between uses. A lubricant is used during sex specifically to reduce friction at that moment. Both can be useful, and many women use both. If dryness is an ongoing problem, using only a lubricant for sex will not address the underlying tissue changes.
Key Ingredients to Look For
The most evidence-backed ingredient in non-prescription vaginal moisturisers is hyaluronic acid, which draws moisture into tissues and has been shown in several trials to be as effective as topical oestrogen for mild to moderate dryness. Polycarbophil-based moisturisers are another well-studied option; they adhere to vaginal tissue and provide sustained hydration. Vitamin E in vaginal formulations can soothe and support tissue integrity. Aloe vera gels are a gentler option for women with sensitivities. Whatever product you consider, check that it is designed specifically for vaginal use, as regular body moisturisers can disrupt vaginal pH.
Ingredients to Avoid
The vaginal environment is delicate. Products containing fragrances, parabens, glycerin (which can encourage yeast growth in some women), or harsh preservatives can cause irritation or infections. Avoid anything not specifically formulated for vaginal or intimate use. Oil-based products should not be used with latex condoms as they degrade latex. Check the pH of the product if possible; products closest to the natural vaginal pH of 3.8 to 4.5 are less likely to cause disruption.
When OTC Products Are Not Enough
For moderate to severe vaginal atrophy, over-the-counter moisturisers may not provide enough relief. Topical vaginal oestrogen, available on prescription, is highly effective and delivers oestrogen locally without meaningful systemic absorption in most cases. This is often recommended by gynaecologists and menopause specialists for women who cannot or do not want to use systemic HRT. A laser therapy called vaginal CO2 laser or MonaLisa Touch is also used clinically for significant tissue changes, though availability and cost vary.
Building a Routine That Works
Consistency is key with vaginal moisturisers. Using one twice a week, even when symptoms are manageable, helps maintain tissue health rather than only treating acute discomfort. Keep the product easily accessible so it becomes part of your routine. If you experience persistent itching, unusual discharge, or pain, see a doctor to rule out infection before attributing symptoms to dryness alone. Tracking how symptoms change over time can help you identify whether your current approach is working or whether a different product or a medical consultation might be needed.
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