Most likely, you don't discuss vaginal dryness with the girls over a glass of rosé as a health concern. However, there's a good chance that someone at the table could relate if you brought it up. Vaginal dryness can affect any woman at any age, but it most frequently occurs when estrogen levels plummet during menopause.
If your vagina is dry, chances are your hormones are to blame. Specifically, estrogen. "The tissue in the vulva and vagina have testosterone and estrogen receptors, means it's sensitive to those hormones. [Their presence] drives blood flow to the tissue," Tami Rowen, M.D., an ob/gyn at UCSF Medical Center specializing in sexual health concerns, tells SELF. Anything that lowers the amount of estrogen circulating in your body will reduce blood flow to the tissue, resulting in dryness of either the vagina or vulva. This may make it tough for you to self-lubricate during sex, or even doom you to a constant state of irritation and discomfort.
The first step in fixing it is to figure out the real cause. Here are the most likely reasons your vagina isn't as lubricated as usual:
When your estrogen level drop dramatically in menopause, the tissue in the vagina becomes thinner, less elastic, and dry, Rowen explains. The collection of menopause-induced changes in the genital area is called genitourinary syndrome of menopause—it used to be called vaginal atrophy. Dryness is a hallmark symptom, as is "irritation, loss of lubrication and pain with sex, an increased risk of UTIs, and even incontinence," Rowen says. Though it typically doesn't start until after age 40, some women go through early menopause in their 30s or even their 20s. Breast cancer treatments like chemotherapy can have a similar effect.
2. Hormonal birth control
Maybe you switched to a new Pill, and noticed your vagina suddenly morphed into the Sahara. It doesn't happen to everyone, but for some women, hormonal birth control causes dryness. The biggest culprit is the Pill, but patches and rings can do it, too. "They mimic the second half of the menstrual cycle, which is a progesterone-dominant, low-estrogen state. So you have less estrogen circling in the body when taking it than you would otherwise," Rowen explains. Non-hormonal birth control like the copper IUD, or progestin-only options like the minipill won't have the same effect.
Postpartum, the pituitary gland releases prolactin, a hormone that tells your body to produce milk. "An elevation in prolactin suppresses ovarian production of estrogen," Rowen says. This also puts your body in a low-estrogen, high-progesterone state—the perfect atmosphere for dryness.
4. Certain health conditions
Some health conditions, like autoimmune condition Sjögren's syndrome, can cause dry mucous membranes and result in problems like dry eyes or dry mouth. "The vagina is a mucous membrane," so it could be impacted as well, Rowen says.
5. Some medications
Anticholinergics, which are commonly used to treat overactive bladder (and off-label to treat excessive sweating), are known to cause vaginal dryness. Some antihistamines like Benadryl can have this side effect, too, as can breast cancer drugs like letrazole. If dryness coincides with starting a new medication, there's a chance there's some cause-and-effect going on.
"There are a host of dermatologic conditions that can cause [vaginal] dryness and pain," Rowen says. Lichen sclerosus, which causes thin, itchy white patches of skin, and lichen planus, which is inflammation of the mucous membranes, are two types of dermatitis that can make the vagina very dry. These conditions can be confirmed with a biopsy, Rowen says, and are treated with steroids. An allergic reaction to detergents or fabrics can also cause skin irritation and throw off moisture balance—always take note if new bath products or laundry detergent doesn't seem to be jiving with your anatomy.
7. Arousal problems
If you only feel dry during sex (read: can't get wet) and not all day every day, it may be that you have a tough time getting aroused. This can stem from so many things from lack of foreplay to relationship problems to hormonal imbalances, and can even be something experts call sexual arousal disorder, which is marked by difficulty responding physiologically to sexual stimulation. If you're having trouble getting turned on, talk to you partner, tell your ob/gyn or a therapist, so you they can figure out what's going on.
“Some studies show that tampons can cause and/or exacerbate vaginal dryness,” women’s health expert Jennifer Wider, M.D., previously told SELF. Turns out that while our monthly helpers are doing their job soaking up menstrual flow, they can also wick away some of our natural moisture in the process. The dryness that may result should only last 12 to 24 hours (it's not going to cause chronic dryness) and can be mitigated by switching to the lightest tampon that will work with your flow.
Figuring out the actual cause of your dryness is key to finding a solution. In the meantime, using an OTC vaginal moisturizer can give you temporary relief and ease discomfort. If your dryness has landed you in the middle of a sexual drought, find a lube that works for you. You might even want to keep using it after your dry spell is long gone.