Disclaimer: This article is for informational purposes only and isn’t a substitute for professional medical advice. Always talk to your doctor or a qualified herbalist before starting a new herb or supplement, especially if you take medication, have a hormone-sensitive condition, or have liver disease. This post may contain affiliate links; if you buy through them, I may earn a commission at no extra cost to you.

Hot flashes get all the attention. Vaginal dryness, discomfort during sex, and changes in libido get whispered about, if they’re mentioned at all — and that silence is exactly why so many women feel like something is wrong with them, rather than understanding it’s one of the most common parts of this transition. Up to half of postmenopausal women experience some form of what’s now clinically called Genitourinary Syndrome of Menopause (GSM), yet it remains one of the most under-treated menopause symptoms, largely because people are too uncomfortable to bring it up. Let’s bring it up.

Why This Happens

As estrogen declines, vaginal and vulvar tissue naturally becomes thinner, less elastic, and produces less natural lubrication. The same hormonal shift can also affect the bladder and urethra, which is why GSM sometimes comes bundled with increased UTI frequency or urinary urgency, not just dryness. This is a direct, well-understood physical response to lower estrogen — it isn’t a sign anything is wrong with you, and it isn’t something you caused.

Libido changes are a separate but related thread, and they’re rarely just about hormones — sleep deprivation, mood changes, body image shifts, and relationship dynamics during this life stage all play a role too. Treating dryness/discomfort and treating desire as two different (if related) conversations tends to be more useful than lumping them together.

Natural and Low-Intervention Approaches

For dryness and discomfort:

  • Water-based or plant-oil-based lubricants for intimacy — avoiding those with glycerin or parabens if you’re prone to irritation or yeast infections.
  • Vaginal moisturizers (different from lubricants — used regularly, not just during intimacy) can rebuild moisture over time rather than providing only in-the-moment relief.
  • Staying sexually active or using a vaginal dilator, if comfortable, which several studies suggest helps maintain tissue elasticity — a “use it or lose it” effect that’s genuinely physiological, not just a saying.
  • Pelvic floor physical therapy — often overlooked, but a pelvic floor PT can address both dryness-related discomfort and pain patterns that develop from tensing up in anticipation of pain.
  • Staying well-hydrated and increasing phytoestrogen-rich foods (flaxseed, soy, chickpeas) — the evidence here is modest, not dramatic, but it’s a genuinely low-risk place to start.

For libido:

  • Prioritizing sleep and stress reduction first — before assuming a supplement or medical intervention is needed, since both sleep debt and chronic stress are well-established libido suppressors on their own.
  • Open conversation with your partner about what’s changed and what feels good now — bodies in menopause often need different kinds of touch or more time to arouse, and naming that directly tends to reduce pressure for both people.
  • Maca root and ginseng are the two herbal options with the most (though still limited) research behind them for libido specifically — worth knowing they’re not equally well-studied as, say, black cohosh is for hot flashes.

When Natural Approaches Aren’t Enough

We built this site around natural remedies, and we’ll always lead with those. But it’s worth saying plainly: for GSM specifically, low-dose vaginal estrogen (cream, ring, or tablet) is extremely effective, carries minimal systemic absorption, and is considered safe for most women — including many who can’t or don’t want systemic hormone therapy for other menopause symptoms. If moisturizers and lubricants aren’t providing enough relief after a few weeks, that’s a reasonable next conversation to have with your doctor, not a failure of the natural approach. Some symptoms respond fully to lifestyle changes; this one sometimes needs a bit more, and there’s no shame in that.

Tools Worth Knowing About

A few companies are approaching this specific gap thoughtfully, worth a look if you want more structured support:

  • Joylux makes at-home devices using light and heat therapy aimed at supporting vaginal tissue health and comfort — a non-hormonal option for women who want to try something beyond moisturizers before considering prescription options. [Learn more →]
  • Interlude offers telehealth specifically built around vaginal dryness, painful sex, and related concerns, with a stated focus on treating these as normal, common issues rather than something to be embarrassed about — useful if you’d rather start this conversation privately, from home, before (or instead of) an in-person appointment. [Learn more →]

The Part Worth Repeating

This isn’t a symptom you have to quietly tolerate for the next 10-30 years. It’s genuinely one of the most treatable parts of menopause, natural or otherwise — the biggest barrier is usually the conversation, not the treatment. If you take one thing from this article, let it be permission to bring this up with your doctor as casually as you’d mention a headache.

What to Read Next

  • [Signs You Might Be in Perimenopause (And What to Do Naturally)]
  • [The Sleep-Menopause Connection: A Natural Wind-Down Routine]
  • [Best Natural Supplements for Hot Flashes: An Honest Comparison]