Say “menopause” and most people will immediately think of hot flashes. While they certainly can be disturbing, there are many other symptoms that women may find equally troublesome. One is vaginal discomfort, which can make intimate relations unpleasant or even painful. Doctors frequently prescribe estrogen, either oral or topical, to help with this problem (Expert Opinion on Pharmacotherapy, May 2019). Others may choose to prescribe ospemifene (Osphena). The research shows that this pill works well to relieve pain during intercourse, although it can lead to some undesirable side effects (Journal of Menopausal Medicine, April 2018). Women sometimes prefer to use topical hyaluronic acid when they wish to avoid hormones and their potential side effects. We have heard from women who report that they use olive oil or coconut oil to ease vaginal dryness. Is that a reasonable approach?
Using Coconut Oil to Ease Vaginal Dryness:
Q. I am of a certain age and have been dealing with vaginal dryness. My gynecologist recommended using coconut oil.
She suggested freezing the coconut oil and using a small melon-baller to create little globes of it. I keep a supply of these in the freezer. Usually one half of a ball is adequate to keep delicate tissues moisturized and comfortable.
A. As far as we can tell, there has not been a scientific study of coconut oil to treat vaginal dryness (atrophic vaginitis). Nevertheless, many readers share your enthusiasm for coconut oil as a lubricant.
One Word of Caution:
Latex condoms may break down in the presence of oils, including coconut oil. What’s more, some people may be sensitive to this natural product. Dermatologists often recommend patch testing any topical treatment by placing a dab on the inside of the forearm. Cover with a bandage and check 24 hours later to see if there is a reaction.
Other Readers Discuss Coconut Oil to Ease Vaginal Dryness:
Q. You have had questions about vaginal dryness from women who are past menopause. I am well past it myself. At 87, I consider myself a crone.
Coconut oil works for me. It doesn’t have the side effects that estrogen, oral or topical, can present. Plus it is cheap and available over the counter. You should suggest it for your readers.
A. Many women agree with you that they find it easy and helpful to use coconut oil to ease vaginal dryness. They apply it intravaginally, just as other women might apply estrogen cream.
Deborah reported:
“My husband and I have been using organic coconut oil for several years with no problems. It is much better than any other lubricant we have tried. Although it could go rancid, we usually have the jar for a year or more at room temp without any problems. It also works well as a lotion for very dry skin.”
Karla made another suggestion, based on her experience:
“I’ve been post menopausal for over 40 years due to a total hysterectomy. About 2 years ago, my doctor diagnosed me with Atrophic Vaginitis because of the horrible burning.
“My daughter is a distributor for natural oils, and she recommended that I try coconut oil. Love it! It works better than Premarin. I put it in a vaginal applicator and then freeze it. Amazon sells vaginal applicators but drug stores don’t.”
Will Sea Buckthorn Work Against Vaginal Dryness?
We heard from another reader who was enthusiastic about sea buckthorn (Hippophae rhamnoides). She sent us a link to a study conducted in Finland (Maturitas, Nov. 2014). This placebo-controlled trial included more than 100 postmenopausal women. Unlike coconut oil, sea buckthorn oil is consumed orally, as a supplement (3 grams/day).
The investigators concluded:
“SB [sea buckthorn] oil showed beneficial effects on vaginal health, indicating it is a potential alternative for mucosal integrity for those women not able to use estrogen treatment for vaginal atrophy.”
We would love to find more research on this alternative treatment. Postmenopausal women deserve all the help they can get, including using coconut oil to ease vaginal dryness.
Hyaluronic Acid as an Alternative to Estrogen Treatment:
Q. After menopause, sex became painful and almost impossible. I tried Estring, an estrogen product you place up inside, but that caused a terrible yeast infection. I tried all kinds of lubricants, but they lost their slipperiness before correcting the pain and dryness.
Then I tried hyaluronic acid. It’s found in some topical products but I take it in capsules. Hyaluronic acid is said to add moisture to skin and joints.
I intended just to lubricate my knee joints from within for easier skiing. What a wonderful surprise when the dryness “down there” started disappearing shortly after I began the capsules.
Now I have sex any time I please, and the pain and dryness are so minimal that they aren’t a problem anymore. Hyaluronic acid is a bit expensive but so very worth it! My knees are doing well too.
What Is Hyaluronic Acid?
A. Hyaluronic acid is a natural compound found in the body’s connective tissues and skin. It has been used as an injection into joints and found to work as well as an oral NSAID similar to ibuprofen (Arthritis Research & Therapy, online Jan. 21, 2014). More to the point, a systematic review found that hyaluronic acid was equivalent to vaginal estrogen for relieving vaginal dryness and discomfort (Journal of Sexual Medicine, Jan. 2021).
In the UK, hyaluronic acid vaginal gel (Hyalofemme) is used to ease vaginal dryness. A study comparing this gel to vaginal estrogen cream showed equal effectiveness (Archives of Gynecology and Obstetrics, Dec. 2013). On the other hand, Italian researchers report that vaginal hyaluronic acid is comparable to a polycarbophil moisturizer similar to Replens (European Journal of Obstetrics, Gynecology and Reproductive Biology, Feb. 1, 2022).
We could find no evidence that oral hyaluronic acid tablets would ease vaginal dryness, but your story is intriguing. We hope to hear from other women if it works for them.
