genitourinary syndrome

Natural Solutions for Vaginal Dryness and the Genitourinary Syndrome of Menopause

woman holding sad face and help sign over crotch

By Chris D. Meletis, N.D.

If you suffer from vaginal dryness—also called vaginal atrophy or atrophic vaginitis—you know firsthand it’s not fun. Often, the first symptom indicating you even have this problem is painful sex. This can really dampen your libido and even make you fear intimacy with your partner.

If misery does indeed love company, the statistics will comfort you. A year after menopause, an estimated 62% to 67% of women have vaginal dryness.1 Up to 85%.1 will be affected by the time they are several years beyond menopause.

You don’t need to be going through menopause to suffer from vaginal dryness. Chemotherapy for anal cancer, estrogen-lowering treatments for breast cancer, or removal of the ovaries or hysterectomies can also lead to vaginal atrophy. And certain diseases such as Sjögren’s Syndrome are linked to this disorder.2 I also see these challenges in some peri-menopause women that are starting to experience changes in their cycle as they approach menopause.

Even though vaginal dryness is really common, sadly only 20% to 25% of women with symptoms actually seek treatment for it.3,4 Many women don’t talk to their doctors about it because they are embarrassed, don’t want a pharmaceutical remedy, or simply accept it as a condition they don’t need to treat.

What is the Genitourinary Syndrome of Menopause?

Vaginal dryness is really part of a larger problem that scientists call the genitourinary syndrome of menopause. Symptoms of this syndrome include not only vaginal atrophy but also itching, burning, vaginal discharge, bleeding after sex, painful urination, and urinary incontinence.3, 5,6

The genitourinary syndrome of menopause happens when your estrogen levels drop over time. The health of the mucous membranes of the urogenital tract (the urinary and genital organs) is dependent upon estrogen levels. Higher estrogen levels are linked to a greater blood supply to the vaginal mucosa, keeping this area lubricated.4 Estrogen can also strengthen the vaginal wall in part through building collagen levels.4 When estrogen levels drop, the vaginal wall becomes thinner. In other words, it atrophies.

Dropping Estrogen Levels Harm Friendly Vaginal Bacteria

The vaginal bacteria—known as the microbiota—pay a price for the drop in estrogen levels that happens after menopause or even after anti-estrogen cancer therapy or removal of the uterus or ovaries. In women who have not gone through menopause, the friendly probiotic bacteria Lactobacillus outnumbers other species.6 These bacteria make lactic acid, which keeps the vaginal fluid at a low pH.6 This protects against urogenital tract infections.6 After menopause or estrogen-lowering therapy, the types of vaginal bacteria can change so that Lactobacillus is no longer the main type.6 This can change the pH of vaginal fluid and lead to vaginal atrophy and the other symptoms of genitourinary syndrome of menopause.6 On the other hand, synthetic hormone replacement therapy (HRT) is known to increase the dominance of Lactobacillus in the vaginal microbiota. This is often associated with reduced vaginal atrophy.7

How Safe is Hormone Replacement Therapy (HRT)?

Although synthetic hormone replacement therapy (HRT) can help reduce vaginal dryness, it causes harmful side effects such as vaginal bleeding and breast pain. In addition, women with a history of breast cancer, or those women with coronary artery disease, active liver disease, and/or who’ve had a stroke should not undergo HRT.8

What Are the Natural Solutions for Vaginal Dryness?

Natural vaginal lubricants are a safe and effective solution for vaginal dryness. Using lubricants that biomatch the vaginal ecosystem and don’t contain harmful ingredients like parabens or phthalates is a supportive way to moisten vaginal walls. Vaginal moisturizers are also able to reduce vaginal pH.4

Choose lubricants and vaginal moisturizers that contain lactic acid. As I mentioned earlier, low estrogen causes a drop in your levels of lactic-acid producing Lactobacillus bacteria. This decline in lactic acid increases the risk of infections and vaginal dryness. Caprylyl glycol is a moisturizing agent considered to be safe and non-toxic by the Environmental Working Group.9 Salvia sclarea (Clary sage) is another great addition to a lubricant. In cell culture studies, it destroyed the cell membranes of Candida albicans,10 the yeast that causes vaginal yeast infections, and E.coli, which can cause urogenital infections.11

Lubricant + Probiotics + Phytoestrogens = A More Comfortable Menopause

Combining a lubricant with dietary supplements containing Lactobacillus probiotics and phytoestrogens is a great way to support health during menopause. For example, red clover may reduce vaginal dryness.12 Maca may reduce a number of menopausal symptoms.13

Licorice and hops both support healthy estrogen levels and therefore may make menopause easier.14 Research has shown that hot flashes don’t last as long after supplementing with licorice.15 By reducing discomfort, all of these ingredients can improve sleep. And the sleep-deprivation that occurs during menopause can actually make vaginal dryness worse.16

Whether it’s called vaginal dryness, the genitourinary syndrome of menopause, vaginal atrophy, or atrophic vaginitis, it’s a frustrating and painful condition. It can seriously dampen your ability to enjoy life. However, using a safe, natural lubricant and taking phytoestrogens and Lactobacillus probiotics, can keep you comfortable and happy.

Dr. Chris Meletis

Dr. Chris MeletisDr. Chris Meletis is an educator, international author and lecturer. His personal mission is “Changing World’s Health One Person at a Time.” Dr Meletis has authored 18 books and over 200 national scientific articles in journals including Natural Health, Alternative and Complementary Therapies, Townsend Letter for Doctors and Patients, Life Extension, Natural Pharmacy, and articles.

Dr. Meletis served as Dean of Naturopathic Medicine and Chief Medical Officer for 7 years for the National College of Naturopathic Medicine (now the National University of Natural Medicine). He was awarded the 2003 Physician of the Year by the American Association of Naturopathic Physician of the Year by the American Association of Naturopathic Physicians. He has a deep passion for helping the underprivileged and spearheaded the creation of 16 free natural medicine healthcare clinics in the Portland metropolitan area of Oregon.


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  13. Meissner HO, Kapczynski W, Mscisz A, Lutomski J. Use of gelatinizedmaca (lepidium peruvianum) in early postmenopausal women. Int J Biomed Sci. 2005 Jun;1(1):33-45.
  14. Hajirahimkhan A, Simmler C, Yuan Y, et al. Evaluation of estrogenic activity oflicorice species in comparison with hops used in botanicals for menopausal symptoms. PLoS One. 2013 Jul 12;8(7):e67947.
  15. Menati L, Khaleghinezhad K, Tadayon M, Siahpoosh A. Evaluation of contextual and demographic factors onlicorice effects on reducing hot flashes in postmenopause women. Health Care Women Int. 2014 Jan;35(1):87-99.
  16. Lee DM, Tetley J. Sleep quality, sleep duration and sexual health among older people: Findings from the English Longitudinal Study of Ageing. Arch Gerontol Geriatr. 2019 May - Jun;82:147-54.

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