Because it stings every time you have sex, you may find yourself shrinking back emotionally before it even starts, or have days when your vagina feels dry, rough and sore even when your underwear brushes against it. It is easy to put this down to age or your general condition. Yet this kind of discomfort is more common than many people think, and even if it is hard to talk about, it is something that can be fully discussed in a medical consultation.
What kinds of discomfort can vaginal dryness cause?
It can show up not only as pain during sex but also as everyday stinging, itching or a dry, rough feeling. That is why some people think of it as “only a problem during sex” and overlook their other symptoms.
- The vaginal opening or inside feels dry and rough, and it stings when your underwear rubs as you walk or sit
- Itching or burning around the vagina
- Pain during or after sex, or a small amount of bleeding
- Needing to urinate often, or repeated bladder infection–like symptoms
Itching and burning in particular also occur with vaginitis or skin conditions of the vulva. This is why it is hard to conclude from symptoms alone that dryness is the cause.
How can I describe the pain I feel during sex?
Rather than just saying “it hurts,” describing when it started, where it hurts and at what moment helps narrow down the cause. It is fine if you struggle to put it into words. Writing down whatever comes to mind and bringing it with you is enough.
| Questions to think through | Examples |
|---|---|
| When did it start? | After I started breastfeeding following childbirth, after I changed my birth control pill, around the time my periods became irregular |
| Where does it hurt? | The opening stings at first contact; a heavy ache deep in the lower abdomen with deep penetration |
| At what moment does it hurt? | Only at the start, throughout sex, a burning feeling that lingers afterwards |
| Any other symptoms? | Itching, discharge or odor that is different from usual, bleeding, stinging when urinating |
Soreness at the opening is often related to dryness or irritation of the vulva, but a pain condition around the vaginal opening or a reflex tightening of the muscles can also be the cause. On the other hand, pain felt deep inside may not be explained by dryness alone, so causes inside the pelvis, such as endometriosis, pelvic inflammation or ovarian cysts, are also looked into. This distinction is not a diagnosis; it is a starting point for deciding what to check during the consultation.
Why does the vagina become dry?
Common backgrounds include times when estrogen falls, certain medicines or treatments, and irritating products. Often several of these overlap rather than just one.
- Hormonal changes: Vaginal secretions can decrease around menopause and afterwards, and during pregnancy and breastfeeding after childbirth. Dryness can also occur before menopause.
- Medicines and treatments: Dryness can follow hormonal birth control pills, some antidepressants, anticancer treatment, or surgery on the uterus or ovaries. Do not stop these medicines on your own; talk with the healthcare professional who prescribed them.
- Irritation: Scented soaps and washes, and washing out the inside of the vagina, can make the skin and mucous membranes more sensitive.
- Physical and emotional state: If you are not fully aroused, or your body is tense from fatigue, nervousness or past experiences of pain, there may not be enough lubrication and pain can feel stronger.
- Other conditions: Underlying conditions such as diabetes or Sjögren’s syndrome, or vaginitis or skin conditions of the vulva, may also be present.
Taking a break from sex for a while to reduce pain, or stopping and talking when it hurts, is also a natural choice. Rather than pushing through the discomfort, it is important to first understand what your body is telling you.
What is the difference between a lubricant and a moisturizer?
A lubricant is for reducing friction during sex, while a vaginal moisturizer is used at regular intervals to ease everyday dryness. The names may sound similar, but they are used at different times and for different purposes.
| Category | Lubricant | Vaginal moisturizer |
|---|---|---|
| When to use | As much as needed just before and during sex | Regularly in daily life, regardless of sex |
| What it helps with | Friction and soreness in that moment | Keeping the inside of the vagina moist |
| When choosing | Consider water-based if you are sensitive to irritation, or silicone-based if you need a longer-lasting slippery feel | Check that the product is made for use inside the vagina |
When using a lubricant, applying it generously to the vaginal opening and the areas that touch tends to reduce friction better than using only a little. If you use latex condoms, avoid oil-based products such as petroleum jelly or baby oil, as they can damage the condom. Do not put creams or lotions that are not made for the vagina inside it.
When should I see a doctor?
If things do not improve after a few weeks of self-care, or if it keeps getting in the way of daily life and sex, please see a doctor. If you have any of the symptoms below, do not dismiss them as dryness; it is best to have the cause checked promptly.
If itching and changes in discharge keep recurring, please also read what to check when vaginitis keeps coming back.
What treatments might be discussed at the clinic?
Treatment is decided according to the cause confirmed by examination. Even with the same dryness, the options differ when the starting point is different.
- If an infection or skin condition is confirmed, treatment for that comes first.
- If the dryness is related to menopause, local hormone (estrogen) treatment applied directly to the vagina may be considered. It is not suitable for everyone, so the decision is made after reviewing your medical history and the medicines you take. Side effects such as headache, vaginal discomfort or bleeding can occur in the early stages of use, so changes during use are also checked.
- If a medicine is suspected of playing a role, you can discuss with the healthcare professional who prescribed it whether there are other options.
- If there is muscle tension or strong worry about pain, ways of addressing pain, such as pelvic floor physical therapy or counseling, can also be discussed.
Some people look into energy-based procedures such as lasers for vaginal dryness. The American College of Obstetricians and Gynecologists (ACOG) explains that the U.S. FDA has not approved these procedures for treating menopausal symptoms or sexual problems, and that they can cause burns, scarring, pain during sex and long-lasting pain. In Korea, the approved purpose of the specific device and the supporting evidence need to be checked separately, and even if you are considering a procedure, first have the cause checked and compare the procedure with other treatment options.
What is checked during a consultation and how it is managed are summarized in LILEAP’s vaginal dryness care guide, and menopausal symptoms in general in the menopause and climacteric care guide.