What can I do to prevent vaginal dryness during sex?

Dear sahara, 

While vaginal dryness (VD) is most common during or after menopause, it can occur at any age. Research indicates that up to 17 percent of premenopausal people assigned female at birth (AFAB) between the ages of 18 and 50 experience problems with vaginal dryness during sex. Insufficient arousal, hormonal changes, and certain medications (to name just a few) can all contribute to vaginal dryness.  

Often (but not always), when your body is sexually stimulated, blood flow increases to the genital regions. The vulva and clitoris swell, and the vagina lubricates itself by secreting a clear and slippery liquid. This type of “wetness” is different from regular vaginal discharge, which changes in consistency with the menstrual cycle and is regularly expelled from the vagina as part of its self-cleaning process.  

Vaginal dryness can be rooted in a number of causes. Falling estrogen levels can thin out the walls of the vagina, causing them to become dry and inflamed. Some factors which can cause your estrogen levels to fluctuate include menopause, breastfeeding, and hormonal birth control. Additionally, using scented or perfumed soaps, washes, and lotions around or in the vagina can also cause skin irritation or infection, which may contribute to vaginal dryness.  

However, not all factors that cause vaginal dryness also originate in this region. For instance, not feeling turned on during sex can make it difficult for your body to get the juices flowing. Insufficient foreplay, stress, self-esteem, and anxiety are all things that can influence your mental state and therefore can interfere with sexual arousal. Vaginal dryness can also be a common side effect of conditions such as Sjogren’s syndrome. It may also be due to certain types of medications like antidepressants, antihistamines, and antibiotics. While there isn’t a lot of research on the effects of dehydration on vaginal dryness, studies have shown that consuming high amounts of alcohol can make the body less sensitive to sexual stimulation. Alcohol also causes your blood vessels to narrow, restricting blood flow all around the body—including the genital areas. This can make it harder to reach or maintain sexual arousal, which may lead to vaginal dryness and delayed orgasm. Nicotine, a chemical found in tobacco products such as cigarettes and e-cigarettes, also has a similar effect on the body.  

What can be done about vaginal dryness? If arousal is something you’re concerned about, engaging in longer foreplay or experimenting with other ways to spice things up in the bedroom might help to turn the faucet on. Though you may be hesitant to use lubricants, they do have benefits. It can help toreduce friction during sex, which may make penetration more comfortable and enjoyable. It can also make sex safer, since rubbing and friction can also cause small tears in the vagina that put you at risk of sexually transmitted infections (STIs). This friction can also make it more likely for condoms to break. As you work through some of these options, some questions you might also ask yourself include: What do I enjoy about the intimate activities that I engage in with my husband? Is there anything I’d like to change? What is it about lubricants that my husband dislikes? What is it that I dislike?  

Even if K-Y doesn’t hold the k(e)y to your heart, the good news is that there are many other varieties of lube available on the market. Some lubes also come with features such as taste, scent, and sensation (like cooling or tingling), which can heighten sexual pleasure. In general, lubricants fall into three categories:  

• Water-based: Safe to use with condoms and sex toys, suitable for sensitive skin, easy to clean up, but may not last as long as other types of lubes. 
• Silicon-based: Safe to use with condoms but may damage silicone sex toys and diaphragms, less sticky, but generally lasts longer than water-based lube. 
• Oil-based: Unsafe to use with condoms, as oil may break down latex and reduce the condom’s effectiveness. 

If you and your partner do decide to give lubricants another go, it’s best to avoid products containing parabens, glycerin, and chlorhexidine (a topical antiseptic). These ingredients can cause skin irritation and disrupt the natural balance of bacteria in the vagina. It’s also recommended to steer clear of lubes containing Polyquaternium-15, a chemical compound that can increase HIV replication.  

Being open with your husband about your feelings of discomfort and how they relate to sexual intimacy in your relationship may help shed light on some causes and solutions. Whether your symptoms are caused by external factors or an underlying health condition, speaking with a health care provider may help provide useful tips on how to manage your symptoms moving forward.  

Take care,