Adult Vaginal Dryness Treatment (Genitourinary Syndrome of Menopause)
Fast MD-only care for postmenopausal vaginal dryness by secure online video visit, $49 flat-fee, no insurance required.
Postmenopausal vaginal dryness is a common part of the genitourinary syndrome of menopause, caused by lower estrogen levels that thin and dry the vaginal and vulvar tissue. Adults may notice burning, itching, pain with sex, or recurrent irritation. Our board-certified MDs use guideline-based evaluation to identify red flags, review prior history, and build an evidence-based plan using nonhormonal and, when appropriate, low-dose vaginal hormone options.
- $49 flat-fee adult visit
- MD-only care (no mid-levels)
- No insurance required
- Secure video visits in 25+ states
Online MD-Only Care for Vaginal Dryness
- Adult-only evaluation focused on postmenopausal vaginal symptoms
- Screening for infection, trauma, and concerning bleeding
- Nonhormonal and, when appropriate, local estrogen options
- Clear criteria for when in-person pelvic exam or gynecology is needed
Adults 18+ only. TeleDirectMD does not manage heavy postmenopausal bleeding, severe pelvic pain, or suspected cancer by telehealth and does not prescribe controlled substances.
What Is Postmenopausal Vaginal Dryness (Genitourinary Syndrome of Menopause)?
Postmenopausal vaginal dryness is usually part of the broader genitourinary syndrome of menopause, a chronic condition in which low estrogen levels lead to thinning, drying, and reduced elasticity of the vaginal and vulvar tissues. This can cause burning, itching, discomfort with daily activities, pain during intercourse, and recurrent irritation or urinary symptoms.
Symptoms often start gradually in the years after menopause and do not improve on their own without treatment. Many adults feel hesitant to bring up these symptoms, but they are very common and highly treatable. Telehealth is often appropriate for initial evaluation and management, as long as red-flag features such as significant bleeding, new pelvic pain, or systemic symptoms are not present.
Symptoms and Red Flags in Postmenopausal Vaginal Dryness
Most cases of postmenopausal vaginal dryness can be addressed through a virtual visit. Certain symptoms, however, suggest infection, trauma, or other conditions that require in-person gynecologic evaluation rather than telehealth alone.
| Symptom | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person care |
|---|---|---|---|
| Dryness, burning, or itching of the vagina or vulva | Common features of genitourinary syndrome of menopause | Yes, often well-suited for telehealth evaluation | Not a red flag alone if symptoms are mild to moderate and stable |
| Pain with intercourse (dyspareunia) after menopause | Often due to vaginal dryness and thinning | Yes, if gradual onset and no bleeding or severe pain | Severe pain, deep pelvic pain, or bleeding with sex |
| Mild urinary urgency or burning without fever | Possible overlap between vaginal atrophy and lower urinary symptoms | Telehealth may help distinguish and guide testing | Fever, flank pain, or systemic illness suggesting kidney infection |
| New vaginal discharge with odor or irritation | Possible infection such as bacterial vaginosis or yeast | Telehealth can often triage and treat based on history | Severe pelvic pain, high fever, or concern for pelvic inflammatory disease |
| Any vaginal bleeding after 12 months without periods | Postmenopausal bleeding that requires evaluation | No, this needs in-person pelvic exam and imaging | Requires prompt in-person gynecologic or primary care evaluation |
| Visible lesion, ulcer, or lump on vulva or in vagina | Possible trauma, infection, or neoplasm | Telehealth can identify concern and guide next steps | Suspicious mass, nonhealing ulcer, or rapidly changing lesion |
| Severe pelvic or lower abdominal pain | Not typical of simple vaginal dryness alone | No | Requires urgent in-person or emergency evaluation |
| Fever, chills, or feeling very ill with genital symptoms | Possible serious infection | No | Needs urgent in-person or emergency care, not a routine telehealth visit |
| History of breast or gynecologic cancer on hormonal therapy | Higher-complexity decision-making around local estrogen options | Telehealth may provide counseling but not definitive management | Requires coordination with oncology or gynecology for treatment choices |
Differential Diagnosis: Vaginal Dryness vs Other Causes of Genital Discomfort
Not all genital discomfort after menopause is purely vaginal dryness. During your TeleDirectMD visit, the MD will review symptom timing, triggers, sexual history, and associated urinary or systemic symptoms to distinguish genitourinary syndrome of menopause from other conditions that may require different treatment or in-person testing.
Genitourinary Syndrome of Menopause (Typical Pattern)
- Gradual onset of dryness, burning, and discomfort after menopause
- Pain with intercourse, reduced lubrication, and irritation with tight clothing
- Thin, pale, or smooth vaginal tissue on prior exams
- Improves with nonhormonal moisturizers and low-dose vaginal estrogen when appropriate
Other Conditions That Can Mimic or Overlap
- Infectious vaginitis: Itching, discharge, and odor from yeast, bacterial vaginosis, or STIs.
- Dermatitis or lichen sclerosus: Chronic vulvar itching, white patches, or scarring.
- Vulvodynia: Chronic vulvar pain or burning without obvious skin changes.
- Neoplasm: Persistent lesions, ulcers, or bleeding that need in-person evaluation and biopsy.
Telehealth can often distinguish these possibilities based on detailed history and prior exam findings. When the diagnosis is uncertain, a lesion is present, or bleeding or significant pain occurs, in-person gynecologic evaluation is recommended.
When Is a Video Visit Appropriate for Vaginal Dryness?
When a Video Visit Is Appropriate
- Adult 18+ with gradual onset of postmenopausal vaginal dryness or discomfort
- Mild to moderate pain with intercourse without heavy bleeding or severe pain
- Stable symptoms without fever, severe pelvic pain, or systemic illness
- Prior pelvic exam or gynecology care that ruled out concerning causes when possible
- Needs help choosing nonhormonal options or discussing local estrogen therapy
- Comfortable discussing sexual and urinary symptoms via secure video visit
- Can seek in-person care locally if the MD identifies red-flag features
Red Flags Requiring In-Person or ER Care
- Any postmenopausal vaginal bleeding, even small amounts
- Severe pelvic or lower abdominal pain
- Fever, chills, or feeling very ill with genital or urinary symptoms
- Visible mass, ulcer, or rapidly changing lesion of the vulva or vagina
- Foul-smelling discharge with significant pain or systemic symptoms
- History of gynecologic cancer with new or worsening symptoms
- New urinary incontinence with weakness or numbness in legs or back pain
If any red-flag symptoms are present, seek in-person or emergency care immediately. TeleDirectMD is not an emergency service and does not replace in-person gynecologic evaluation for bleeding, severe pain, or suspected malignancy.
Treatment Options for Postmenopausal Vaginal Dryness
Effective treatment for postmenopausal vaginal dryness focuses on restoring moisture, improving tissue health, and reducing pain with daily activities and intercourse. Our MDs follow evidence-based guidelines and tailor therapy to your symptoms, medical history, and preferences, starting with nonhormonal options and considering low-dose vaginal estrogen when appropriate.
Nonhormonal Measures and Lifestyle Strategies
- Use vaginal moisturizers regularly (not just during sex) to support baseline hydration.
- Choose water-based or silicone-based lubricants during intercourse to reduce friction and pain.
- Avoid perfumed soaps, douches, and harsh products that can further irritate the area.
- Wear breathable cotton underwear and avoid prolonged dampness after swimming or exercise.
- Consider pelvic floor physical therapy or sex therapy referral when pain and anxiety are strongly linked.
Hormonal and Prescription Options (When Appropriate)
- Low-dose vaginal estrogen cream, tablet, or ring for adults without contraindications to local estrogen.
- Nonhormonal prescription moisturizers or inserts when available and clinically appropriate.
- Coordination with oncology or gynecology before any hormonal therapy in those with a history of hormone-sensitive cancer.
- Discussion of systemic options such as oral SERMs or other agents when indicated, typically managed with in-person specialists.
TeleDirectMD emphasizes careful screening for bleeding, cancer history, and cardiovascular or thrombotic risk before hormonal treatment. Some therapies may require in-person pelvic examination, baseline labs, or specialist involvement before starting or continuing.
Common Medications Used for Postmenopausal Vaginal Dryness
The exact regimen is individualized based on symptom severity, cancer history, cardiovascular risk, and prior treatment response. The table below shows typical examples your MD may discuss. Not all medications listed will be prescribed in every telehealth visit.
| Medication | Dose | Duration | When it is used |
|---|---|---|---|
| Vaginal moisturizer (nonhormonal, OTC) | Apply intravaginally and to vulva as directed, often every 2–3 days | Ongoing as part of baseline care | First-line option for mild to moderate dryness and those avoiding hormones |
| Water-based or silicone-based lubricant (OTC) | Apply to vaginal opening and partner or device before intercourse | Used as needed for sexual activity | Reduces friction and pain with intercourse in most adults with dryness |
| Estradiol 0.01% vaginal cream | Example: 0.5–1 g intravaginally nightly for 2 weeks, then 2–3 times per week | Long-term local therapy with periodic reassessment | Moderate to severe postmenopausal vaginal atrophy in adults without contraindications |
| Estradiol 10 mcg vaginal tablet | Example: 10 mcg intravaginally daily for 2 weeks, then 2 times per week | Long-term local therapy as tolerated | Adults preferring low-dose, convenient local estrogen with minimal systemic exposure |
| Estradiol vaginal ring (low-dose) | Ring inserted intravaginally and left in place for up to 90 days | Replace every 3 months if continued | Selected adults wanting a low-maintenance local estrogen option when appropriate |
| Other systemic or specialty therapies | Dose and schedule individualized by gynecology or oncology | Requires in-person specialty oversight | Complex cases with severe symptoms or overlapping conditions, not started solely by brief telehealth visit |
These are example regimens only. Actual medications, strengths, and durations are determined by the MD after reviewing your history, cancer risk, cardiovascular profile, other diagnoses, and concurrent medications. Some therapies may require in-person pelvic examination, specialist input, or additional testing before they are started or continued. TeleDirectMD does not prescribe controlled substances via telehealth.
Home Care, Expectations, and Return to Work
Genitourinary syndrome of menopause is chronic but very treatable. The goal is to reduce dryness, pain, and urinary symptoms so that daily activities and sexual health feel more comfortable and predictable.
- Use moisturizers and any prescribed treatments exactly as directed for several weeks before judging response.
- Expect gradual improvement over 2–12 weeks, with continued benefit as therapy is maintained.
- Continue gentle genital hygiene, avoiding harsh soaps, wipes, or douching.
- Discuss any new bleeding, pain, or lesions promptly, rather than assuming they are part of dryness alone.
- Schedule follow-up if symptoms are not improving or if you have questions about long-term use of local therapies.
Most adults with vaginal dryness can safely attend work and usual activities. If a work note is needed, TeleDirectMD can generally provide documentation of evaluation and treatment rather than recommending time off, unless other medical issues are present.
TeleDirectMD Telehealth Disclaimer
TeleDirectMD provides MD-only virtual urgent care for adults using secure video visits to evaluate conditions like postmenopausal vaginal dryness and genitourinary syndrome of menopause. Visits are $49 flat-fee with no insurance required and are available in 25+ states. Our physicians follow evidence-based guidelines, clarify what can be safely managed via telehealth, and explain when in-person primary care, gynecology, or emergency evaluation is more appropriate. TeleDirectMD is not an emergency service or a replacement for comprehensive in-person care.
Postmenopausal Vaginal Dryness Treatment FAQs
After menopause, estrogen levels fall and the vaginal and vulvar tissues become thinner, drier, and less elastic. This change in the tissue, called genitourinary syndrome of menopause, reduces natural lubrication and can cause burning, itching, and pain with intercourse. It is a biologic change, not a sign of poor hygiene or lack of interest in sex.
Yes, many adults with gradual vaginal dryness and pain with intercourse can be safely evaluated by an MD via secure video. We review your symptoms, history, prior exams, and cancer risk and then recommend nonhormonal measures and, when appropriate, discuss low-dose vaginal estrogen. If we identify red-flag features such as bleeding or severe pain, we will direct you to in-person care instead of managing it fully online.
Many people notice some improvement in comfort within 2–4 weeks of consistent use of moisturizers and local treatments, with continued gains over 8–12 weeks. Because genitourinary syndrome of menopause is chronic, ongoing use of moisturizers and, when appropriate, low-dose estrogen is usually needed to maintain benefits rather than expecting a one-time cure.
Depending on your symptoms and history, we may recommend regular use of vaginal moisturizers, lubricants during intercourse, and in suitable candidates, low-dose vaginal estrogen in the form of a cream, tablet, or ring. We may also discuss nonhormonal prescription options and coordinate with gynecology or oncology when your history requires in-person specialist input before starting hormonal therapy.
For people with a history of hormone-sensitive cancer or blood clots, decisions about any estrogen exposure, even low-dose local therapy, need careful review with their oncology or gynecology team. TeleDirectMD can provide general education, but we typically avoid starting vaginal estrogen without coordination with your in-person specialists when you have a complex history or unclear risk profile.
Even when symptoms sound typical for genitourinary syndrome of menopause, periodic in-person pelvic exams are important to screen for other conditions, evaluate any lesions or bleeding, and review cancer screening. A telehealth visit can help you understand likely causes and treatment options, but it does not permanently replace in-person pelvic exams and gynecologic care when they are due or needed for new findings.
Vaginal dryness and discomfort are common after menopause, but you do not have to live with significant pain or avoid intimacy because of them. Moisturizers, lubricants, and local therapies can greatly improve comfort and quality of life. The first step is talking about your symptoms so that an MD can help build a reasonable, evidence-based plan that fits your goals and health history.
Any vaginal bleeding more than 12 months after your last period deserves in-person evaluation, even if it is light or only occurs after intercourse. While some minor spotting can come from fragile atrophic tissue, bleeding can also signal polyps, hyperplasia, or cancer. Telehealth can help you understand why prompt evaluation is recommended, but bleeding should not be managed by telehealth alone.
Regular sexual or vaginal activity can help maintain blood flow and tissue health, but it does not fully prevent the tissue changes of menopause. Pain, anxiety, and relationship dynamics can also influence how dryness is experienced. Treatment often works best when we address both the physical dryness and the emotional or relationship impacts, sometimes with pelvic floor therapy or sex therapy in addition to medical treatment.
TeleDirectMD offers MD-only, guideline-based care for postmenopausal vaginal dryness through secure video visits with a simple $49 flat-fee model and no insurance required in 25+ states. We focus on clear explanations, practical nonhormonal strategies, careful use of local estrogen when appropriate, and explicit guidance on when in-person gynecology or urgent care is safer than telehealth alone.