The Best Lubricants for Menopause Dryness, Chosen by a Women's Health Editor

Women's health has been a recurring focus of my life, beginning as a young woman doing community volunteer work. But as steeped as I am in medical and traditional reproductive health facts, I was at a loss when I went through menopause, since the topic has long been under-studied and misunderstood (even shamed) in popular culture. So many conflicting opinions, waves of scientific data and individual responses to the condition, I didn't know what was coming. Who even knew, as a young woman, that finding the best lubricants for menopause dryness was going to be super-important? Including daily use as a personal moisturizer and for sex during menopause, for sensitive skin and various ingredient preferences (oil-based, organic, etc.), there's a lot of preferences to consider. Women, sooner or later you'll find out first-hand that this personal care product is essential, right before during and yes even after your periods stop completely—because the end of menopause doesn't mean the end of lubrication).

The Cleveland Clinic sums up menopause as “a point in time when a person has gone 12 consecutive months without a menstrual period. Menopause is a natural part of aging and marks the end of your reproductive years.” On average, this event occurs at age 51, and besides your period ending, involves other natural occurrences including hot flashes, "menopause brain" aka brain fog, mood swings, joint pain, painful sex and irritability. While numerous women’s health advocates we spoke with agreed that there’s an increased conversation among the public and media (TikToks even) about menopause, one “time of life” symptom that often gets ignored is vaginal dryness.

First, I interviewed experienced health care professionals about how and why to use moisturizers and lubricants during perimenopause, menopause and post-menopause. Next, I pored over reviews posted by users who opined about formulations, ingredients and how the products felt to use. And I personally tested many of these products, which I've addressed on a product-by-product basis. I have come away from my deep dive into the best lubricants for menopause dryness, and want to spread the message that menopausal discomfort is totally treatable and a better quality of life is achievable. And I continue to depend on many of these products today.

“When you go through menopause, your body’s estrogen levels fall by about 90 percent,” says Dr. Pelz. She says that in addition to hot flashes, irritability, and fatigue, “there’s also a less talked-about (but important!) side effect of low estrogen: vaginal dryness. Estrogen regulates the vagina’s lubrication and elasticity, and when estrogen levels drop, a lot of menopausal women experience dryness as a result.”

Dr. Prabakar adds that, “when it comes to vaginal and vulvar dryness specifically, this type of dryness can cause vaginal bleeding. When the tissue becomes so dry, it can chafe easily and cause bleeding. This is the most common cause of postmenopausal vaginal bleeding and can also affect the urethral tissue due to the lack of estrogen. This causes frequent urinary tract infections in women above 50.” The menopause expert goes onto explain that the lack of estrogen in the vulva can also affect the urethra and the bladder, a fact that most women do not know. "So when you replenish the estrogen in the vulva, you are also helping with symptoms like urinary urgency, frequency and sometimes incontinence," she says. "So vaginal estrogen is such an important treatment to consider post-menopause."

During menopause, the vaginal skin “appears, due to lack of estrogen, to thin and enters a dormant state,” says Dr. La Follette. “So the elasticity, the lubrication and normal pH of the vagina are lost. The vagina skin loses elastin and collagen and becomes thin, dry and friable. The pH of the vagina increases (the vagina become less acidic) and can lead to vaginal infections like yeast and bacterial vaginosis.”

“There are products that are used on a daily or weekly basis to maintain hydration in a similar fashion to the creams we apply to our face. These are viewed as vaginal moisturizers rather than lubricants,” Dr Fenske says. For instance, Womaness Daily V Soothe (part of a brand Dr. Fenske advises) is a daily water-based hyaluronic acid formula that is meant to maintain the moisture of the vagina and be used as part of a skincare regimen. “There are also lubricants that are used for lubrication for vaginal penetration and to help reduce friction,” says Dr. Fenske. “These lubricants can be water-based, silicone-based or oil-based.”

Why are there separate formulations for sex during menopause? It's because the body's usual lubrication has been lessened by peri- or menopause. “As a result of hormone fluctuations during menopause, vaginal secretions lessen and (even when a woman is sexually stimulated) the vagina may remain dry which can make sex painful,” says Dr. La Follette. “The vagina also becomes less acidic, which increases the risk of infection and irritation. Intercourse becomes painful as now the vaginal skin has changed to a thin non-elastic and non-lubricated membrane: bleeding and pain with sex can occur.” In her practice, she recommends a three-pronged treatment: moisturize, lubricate and apply a vaginal estrogen.

Vaginal estrogens, which come in formulations including a ring, a vaginal pill or a vaginal cream, are effective and safe ways to combat vaginal dryness as well as urinary symptoms, according to Dr. Prabakar. However, lingering controversies surrounding hormone therapy leave many women reticent to undertake it and doctors hesitant to prescribe it. (Unlike the over-the-counter remedies we’ve outlined here, vaginal estrogen requires a prescription from a doctor.) Dr. La Follette is unstinting in her assessment: “One of the great disservices of the FDA is that despite many studies of the safety of vaginal estrogen, even in women with breast cancer, the package insert is an alarmist inaccurate treatise. Namely, vaginal estrogen remains enormously safe and even the statistics in the black box warning in the vaginal estrogen package are misleading.”

It's between you and your doctor if prescription medicines (or procedures, such as the laser treatment one of our friends undertook, that was also lauded by Dr. La Follette) are right for you. In the meantime, there are a bathroom cabinet’s worth of non-prescription formulations to lessen the discomfort and lube up the vagina, outlined above.

• Dr. Cheruba Prabakar is one of The Luna Daily Collective of medical advisors and a board certified OBGYN who specializes in treating women with heavy periods, abnormal bleeding, fibroids, polyps, endometriosis, and infertility. She is passionate about helping women with fibroids live a life free of bleeding and pain. She also treats many women who are undergoing IVF and need small polyps or fibroids removed from their uterus prior to their fertility treatments. Dr. Prabakar is also a nationally certified menopause practitioner and helps women through the transition with hormone therapy.
• Dr. Suzanne Fenske, MD, FACOG, ABIOIM, NCMP is an Ob/Gyn partner of Womaness, a female-led company whose high-performance collection of supplements, skincare and sexual wellness items are bringing greater access, visibility, pleasure and joy to 40+ woman to help them easily and unapologetically embrace their wellness needs.
• Lizellen La Follette is a globally recognized leader, educator and researcher focused on comprehensive healthcare for women, including birth control options, safe birth, and vaginal birth after cesarean (VBAC) deliveries, along with aging strategies before, during and after menopause. La Follette is an advisor to Stripes, the Naomi Watts-backed company that helps women age comfortably by creating products using natural and sustainable ingredients.
• Dr. Mindy Pelz, a leading women’s health expert, is the author of the bestselling book The Menopause Reset, a guidebook for women struggling with sudden menopause symptoms including sleepless nights, irritable moods, unexplained anxiety, trouble retrieving words, weight gain and hot flashes.

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