Vaginal dryness and burning
Vaginal dryness, burning, irritation, or a “raw” sensation is common — especially after childbirth, during breastfeeding, and around perimenopause or menopause. With correct diagnosis, vaginal dryness can be treated safely and effectively, improving comfort, sexual health, and quality of life.
Symptoms and Common Causes
Symptoms
- Dryness or tightness
- Burning or irritation
- Pain during sex
- Bleeding after sex from micro-tears
- Recurrent infection-like symptoms but tests are negative
- Itching without discharge
- Pain while wiping or washing
- Increased urinary urgency or burning without UTI
Common causes
- Perimenopause / Menopause (Genitourinary Syndrome of Menopause)
- Postpartum / Breastfeeding low estrogen
- Hormonal contraception-related dryness
- Recurrent infections or over-treatment
- Vulvar skin conditions (dermatitis, lichen sclerosus)
- Psychological / pelvic floor factors causing pain-tightening cycle
Evaluation and Tests
Initial evaluation
- Symptom pattern mapping: burning vs itching vs pain, triggers, onset
- Discharge assessment: presence vs dryness
- Examination: tissue thinning, inflammation, fissures, skin changes
- Targeted tests only if needed (vaginal swab, urine test, Pap smear/HPV, rare biopsy)
Treatment Options
Barrier restoration and comfort
- Medical-grade vaginal moisturizers
- Lubricant guidance for intercourse
- Avoid irritants: soaps, perfumes, internal washes
- Correct hygiene approach
Local estrogen therapy
- Restores vaginal thickness, elasticity, and lubrication
- Reduces burning and pain
- Helps urgency and recurrent urinary symptoms
- Low systemic absorption
Non-hormonal alternatives
- Non-hormonal moisturizers
- Hyaluronic acid-based therapy
- Tissue-support regimens
- Lifestyle and trigger correction
Pelvic floor therapy
- Pelvic floor relaxation
- Graded dilation
- Pain cycle reversal plan
Infections or vulvar disorders
- Treat infections only when confirmed
- Targeted therapy for dermatitis or lichen changes
