What it is
Vaginal moisturizers are non-hormonal gels or inserts used in the vagina on a regular schedule, most often two to three times a week, to hydrate vaginal tissue and relieve dryness, irritation, and painful sex caused by genitourinary syndrome of menopause (GSM). Unlike lubricants, which are used with sexual activity, moisturizers are used regularly regardless of when you have sex. Common ingredients include polycarbophil, a bioadhesive polymer that helps the gel stick to the vaginal wall, and hyaluronic acid. They are available over the counter without a prescription.
How well it works
The MsFLASH Vaginal Health Trial (Mitchell et al., JAMA Internal Medicine, 2018; n=302) was a 12-week double-blind trial in postmenopausal women with moderate to severe symptoms. It compared a polycarbophil moisturizer, a low-dose vaginal estradiol tablet, and dual placebo. 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. NAMS notes that the placebo gel likely had lubricating properties, and that few clinical studies have been conducted on the efficacy of these products.
The NAMS 2020 GSM position statement lists nonhormone lubricants and regular use of long-acting vaginal moisturizers as first-line therapies for GSM, 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
There are no published reports on the irritation potential of over-the-counter vaginal moisturizers and lubricants, so NAMS suggests testing a product on a small patch of skin for 24 hours before using it in the vagina. If it still causes irritation in the vagina, you can switch to an iso-osmolar or propylene glycol-free product. In the MsFLASH trial, increased vaginal secretions and vaginal itching were reported at similar rates with the moisturizer and the placebo gel.
Where to get it
Vaginal moisturizers are available over the counter 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. Check our provider directory for clinics near you.
