How often should I use vaginal moisturisers?
Most people with genitourinary syndrome of menopause (GSM) feel best using a vaginal moisturiser on a schedule—typically 2–4 times per week—then adjusting to the lowest frequency that keeps day-to-day comfort steady. Moisturisers support tissue hydration between uses; they’re different from lubricants, which reduce friction at the time of sex or examinations. Combine with gentle vulval care and the right personal lubricant; consider local oestrogen or DHEA if dryness persists. Educational only. Results vary. Not a cure.
Detailed Medical Explanation
How often should I use vaginal moisturisers? A good starting point is 2–4 applications per week, spaced out (for example, every other night), and then taper to the lowest schedule that maintains comfort once symptoms settle. Vaginal moisturisers are designed to rehydrate and support the vaginal epithelium between uses, which is why they help with background dryness, a scratchy or sandpaper-like sensation on walks or cycling, stinging when urine touches delicate skin, and superficial fissures or micro-tears at the entrance. This pattern of symptoms sits within genitourinary syndrome of menopause (GSM), previously called atrophy.
Why a schedule matters. In peri- and post-menopause, lower oestrogen reduces glycogen (fuel for lactobacilli), raises pH, and thins the epithelium—so the tissue holds water less well. Moisturisers (many include hyaluronic acid) act like “skin care for the vagina”: they draw in and retain moisture, improving elasticity and comfort over days, not minutes. That’s different from personal lubricants, which are used just in time for sex, examinations or dilator work to reduce shear forces immediately. Most people benefit from both: a moisturiser routine for background comfort and a lubricant during higher-friction moments.
Building the routine. Pick set days (e.g., Mon–Wed–Fri) so applications aren’t bunched together. Aim for bedtime when you’ll be horizontal, which reduces leakage. Start with a pea-to-almond-sized amount intravaginally (follow the product’s directions); a thin layer externally on the vestibule can help if the entrance is your tender spot. After 2–3 weeks, reassess. If you’re comfortable every day, try stepping down to twice weekly; if symptoms creep back, step up again. Consistency beats intensity—the right schedule is the least frequent use that keeps you well.
Practical tips to boost comfort. Use lukewarm water to rinse and a bland emollient as a soap substitute externally; avoid fragranced washes, wipes and bubble baths. Choose breathable underwear and change out of sweaty gym kit promptly. For intimacy, plan unhurried arousal and use a suitable lubricant: water-based (versatile, condom-friendly), silicone-based (long-lasting glide, helpful for dyspareunia), or oil-based (rich feel but may degrade latex condoms and some toys). If pelvic floor muscles have tightened after pain, pelvic health physiotherapy and, where helpful, graduated dilator work can reduce the sharp, burning entrance pain that sometimes persists even when hydration improves.
When moisturisers aren’t enough. If you remain sore despite a steady routine over several weeks, discuss adding local vaginal oestrogen (cream, tablet/pessary, or estradiol ring) or vaginal DHEA to restore lubrication, elasticity and pH. Systemic HRT can help vasomotor symptoms but often needs pairing with local therapy for GSM. To understand how we structure care and what to expect, see our clinic pages on how treatment steps are sequenced and answers in our treatment FAQs.
Safety notes. If you notice new malodorous or greenish discharge, intense itching with thick white discharge, ulcers or white plaques, fever, pelvic pain, visible blood in urine, or post-menopausal bleeding, seek assessment rather than increasing moisturiser frequency; these features may indicate infection or a skin condition (e.g., lichen sclerosus) that needs specific treatment. Patch-test if you have sensitive skin, and avoid strong fragrances or “warming” additives that can sting.
Clinical Context
Who may need more frequent use initially? People with pronounced dryness, recurrent micro-tears, or persistent dyspareunia; those after surgical menopause; or anyone who paused care during illness or travel. A 3–4 times weekly schedule for 2–4 weeks is common before stepping down.
Who might use less? If symptoms are mild and mainly situational (sex, speculum exams), twice-weekly moisturiser plus a reliable lubricant often suffices. People with sensitive skin or contact dermatitis benefit from fragrance-free, low-irritant products and simple external skin care.
Alternatives and next steps. When moisturisers alone don’t maintain comfort, local vaginal oestrogen or vaginal DHEA are evidence-based add-ons. For entrance-focused burning with normal hydration, consider pelvic floor over-activity or vestibulodynia—physiotherapy and psychosexual therapy can help. Plan a 6–12-week review to adjust to the lowest effective maintenance schedule. If infections are confirmed, treat specifically; once settled, return to a moisturiser routine to prevent friction-related flares.
Evidence-Based Approaches
UK guidance supports starting with non-hormonal measures and escalating when symptoms affect quality of life. The NICE Menopause Guideline (NG23) recommends offering information on vaginal moisturisers and lubricants, and considering low-dose local vaginal oestrogen with or without systemic HRT. NHS pages on vaginal dryness and painful sex (dyspareunia) provide practical self-care and red-flag advice.
Randomised trials synthesised in the Cochrane Library show that local oestrogens improve dryness, soreness, dyspareunia and vaginal pH versus placebo across creams, pessaries/tablets and rings, with low systemic absorption at licensed doses. Peer-reviewed overviews indexed on PubMed discuss GSM mechanisms (thinner epithelium, raised pH, loss of lactobacilli), positioning of hyaluronic-acid moisturisers, and roles for vaginal DHEA, pelvic floor and psychosexual approaches. For UK product information and cautions, see the British National Formulary (BNF).
How to apply this evidence: Use a moisturiser 2–4 times weekly at first; pair with a compatible lubricant for higher-friction moments; review at 6–12 weeks; then step down to the lowest frequency that keeps symptoms controlled, adding local therapy when needed for sustained relief aligned with guidelines.