What it is
Vaginal moisturizers are non-hormonal gels or creams inserted into the vagina on a regular schedule, typically every 2 to 3 days, to hydrate vaginal tissue and relieve dryness, irritation, and painful intercourse caused by genitourinary syndrome of menopause (GSM). Unlike lubricants, which are applied at the time of sexual activity, moisturizers are used on an ongoing basis regardless of when you have sex. Common active ingredients include polycarbophil (a bioadhesive polymer that binds to vaginal tissue and retains water) and hyaluronic acid. They are available over the counter without a prescription.
How well it works
The largest randomized controlled trial of vaginal moisturizers is the MsFLASH Vaginal Health Trial (n=302), a 12-week double-blind study published in JAMA Internal Medicine in 2018. It compared a polycarbophil moisturizer (Replens), a low-dose vaginal estradiol tablet, and dual placebo. The result was surprising: all three groups improved similarly, and neither the moisturizer nor the estradiol was significantly better than placebo for the primary endpoint of most bothersome vulvovaginal symptom severity. Open-label studies without placebo controls report improvements in vaginal health index and dryness scores, but without a placebo arm, placebo effects cannot be separated from true treatment effects.
The Menopause Society (NAMS 2020 GSM Position Statement) recommends vaginal moisturizers and lubricants as first-line nonhormone therapy for mild GSM symptoms, noting that nonprescription therapies provide sufficient relief for most women with mild symptoms. For moderate to severe GSM, prescription options such as vaginal estrogen, vaginal DHEA, or ospemifene are recommended.
Side effects and cautions
Vaginal moisturizers are generally well tolerated. The most common side effects are mild, transient vaginal irritation or burning, increased discharge, and itching. Discontinue use and consult a healthcare provider if irritation persists. People with known hypersensitivity to any ingredient (such as polycarbophil, hyaluronic acid, or propylene glycol) should avoid products containing those ingredients. Some product labels advise against use during an active vaginal infection.
Where to get it
Vaginal moisturizers are available over the counter at pharmacies, grocery stores, and online without a prescription. They do not require a doctor’s visit, though a healthcare provider can help determine whether your symptoms warrant prescription treatment instead.