Menopause symptoms · Ontario

Vaginal dryness and GSM

Medically reviewed by Dr. Nathan Roth, MDCM, FRCSC, FACOG · Updated 2026-11-01

How is vaginal dryness from menopause treated?

Vaginal dryness is part of genitourinary syndrome of menopause (GSM), caused by low estrogen in vaginal and urethral tissues. Moisturizers and lubricants help comfort; low-dose vaginal estrogen is highly effective with minimal systemic absorption for most women and can be used long-term when indicated. Systemic HRT alone may not fully treat GSM. Ontario clinicians at HormoneFit can guide options.

  • GSM is chronic without treatment — it does not “just pass”
  • Low-dose vaginal estrogen is first-line for many women
  • Systemic HRT treats flashes but may not fully fix GSM
  • Breast cancer survivors need individualized specialist counseling

Why it happens

Estrogen maintains vaginal blood flow, elasticity, and lubrication. After menopause, tissues thin and pH rises, increasing dryness, irritation, painful sex, and sometimes urinary urgency or UTIs.

Treatment options

Regular vaginal moisturizers and lubricants for sexual activity are foundational. Low-dose vaginal estradiol or estriol preparations and DHEA (prasterone) where available act locally. Guidelines support vaginal estrogen for symptomatic GSM; discuss history of estrogen-sensitive cancer with your clinician before use.

Vaginal estrogen explained

References & guidelines

  1. The Menopause Society — GSM / vaginal estrogen guidance
  2. SOGC menopause and genitourinary health resources

Educational only — not personal medical advice. Virtual HormoneFit visits are private-pay membership care. In-person OHIP-insured consultations are arranged separately when medically indicated. Book a virtual visit or view care plans.

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