by Dr. Sally Greenwald
Private Medical Senior Consultant on Women’s Health
Vaginal dryness, irritation, and pain with sex are common during perimenopause and menopause, but the options for treating these symptoms are often talked about as if they’re interchangeable. New data presented this year help clarify why they’re not.
About Dr. Greenwald
Dr. Greenwald contributes regularly to the field of sexual and menopausal medicine and is a member of The Menopause Society as well as a Fellow of the American College of Obstetricians and Gynecologists. |
New data in 2025
At the 2025 Annual Meeting of The Menopause Society, a leading professional organization in women’s midlife health, researchers shared new real-world data1 on non-hormonal approaches to vaginal symptoms.
One large consumer survey followed more than 2,000 women using a hyaluronic acid–based, hormone-free vaginal moisturizer for at least 30 days. Most participants reported moderate to severe symptoms before treatment, and the majority reported meaningful improvement in dryness, discomfort, and pain with sex over time, along with improvements in daily comfort and quality of life.¹
Please note these options are for localized symptom relief of the vagina, and do not take the place of systemic hormone therapy used for systemic symptoms such as hot flashes. Additionally, while some women get local vaginal symptom relief from systemic hormones, many women on systemic hormones also need local hormones or other therapies as described here.
Treatment overview
Here’s how clinicians think about these treatments:
Vaginal estrogen is a local hormone therapy that treats the underlying tissue changes caused by estrogen loss. It’s the most effective option for ongoing symptoms related to genitourinary syndrome of menopause.
Non-hormonal vaginal moisturizers are designed for regular use to improve hydration and comfort. They don’t change hormone levels or tissue biology, but for some women, especially those who cannot or prefer not to use hormones, they can significantly reduce symptoms.
Lubricants provide short-term relief during sex by reducing friction, but they don’t treat dryness or discomfort outside that moment.
Watch Dr. Sally Greenwald on Peter Attia’s podcast
Dr. Greenwald joined “The Drive” podcast in October 2025 to share the latest evidence on women’s health.
Takeaway
The takeaway from our physicians: vaginal symptoms deserve targeted solutions.
New data from respected menopause experts reinforce that there is no single “right” option for everyone. The best choice depends on symptoms, preferences, and individual health history, not a one-size-fits-all approach.
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