Vaginal dryness is one of those symptoms that almost every woman experiences at some point during perimenopause or menopause… but very few feel comfortable talking about. It can show up as irritation, itching, discomfort, or pain with intimacy – and for many women, it quietly impacts confidence, relationships, and overall quality of life.

And here’s the thing. When oestrogen declines – whether that’s perimenopause, menopause, or even certain medications – the vaginal tissue loses its ability to stay hydrated and repair itself. Over time, this leads to thinning, dryness, and increased sensitivity.

This is often referred to as genitourinary syndrome of menopause (GSM) and it affects far more women than we openly talk about.

The good news? There are options. And one that’s gaining increasing attention, for good reason, is hyaluronic acid.

What is hyaluronic acid – and why does it matter here?

Hyaluronic acid is a natural substance found throughout the body, particularly in the skin, joints, and connective tissue. Its primary role is to act as a lubricant and moisturiser, helping tissues retain water and maintain hydration, elasticity, and structure.

As we age, levels of hyaluronic acid naturally decline. Combined with falling oestrogen levels, this can contribute to dehydration and thinning of local tissues, including vaginal tissue, which is why many women start to notice increased sensitivity and dryness during perimenopause and menopause.

Why vaginal dryness happens during menopause

Oestrogen plays a key role in maintaining the health of vaginal tissue.

As levels decline, the tissue becomes thinner, less elastic, and less able to maintain natural moisture. Blood flow to the area can also reduce, and the tissue becomes more fragile and prone to irritation.

This is why vaginal dryness isn’t just about discomfort — it can impact:

• Comfort in day-to-day life
• Sleep and movement
• Intimacy and relationships
• Confidence and self-esteem

And importantly, these symptoms can persist if not addressed.

How hyaluronic acid works (the science, in plain English)

Hyaluronic acid works by supporting hydration at a tissue level.

When applied locally as a vaginal moisturiser (such as a gel, cream, or suppository), it helps draw water into the vaginal mucosa and retain that moisture over time. This improves hydration, elasticity, and overall tissue comfort, It also forms a protective barrier, which helps maintain longer-lasting moisture and reduces ongoing irritation.

There’s also evidence that hyaluronic acid supports tissue repair processes by improving the local environment of the tissue, helping it function more effectively despite the hormonal changes occurring in the background, So rather than simply providing temporary relief, it helps support the tissue in a more sustained way.

What the clinical research shows

The evidence for hyaluronic acid in vaginal dryness is both growing and consistent.

Research highlights hyaluronic acid as a good option for managing symptoms such as vaginal dryness and discomfort, particularly in women seeking non-hormonal approaches. This is because of its ability to improve hydration, elasticity, and overall tissue health. Results also show it improves symptoms such as vaginal dryness, burning, and discomfort, supporting its role as an effective non-hormonal option.

Interestingly, research shows that hyaluronic acid provides comparable relief to oestrogen therapy. 

What’s particularly important is the consistency of these outcomes across studies. When multiple trials and reviews show similar results, it strengthens confidence that the effect is meaningful.

How to use a hyaluronic acid vaginal moisturiser

One of the most important things to understand is that vaginal moisturisers are designed for regular use, not just when symptoms appear. Products are typically applied using a finger or an applicator and are often best used at night, as they can sometimes feel a little messy during the day.

Most are used every few days – commonly around every three days = depending on the formulation and individual needs.

It’s also important to set expectations. It can take several weeks to months of consistent use to restore moisture and improve symptoms. And if you stop using the product, dryness may return, which is why ongoing use is often recommended.

Is hyaluronic acid safe for vaginal use?

For most women, hyaluronic acid-based vaginal moisturisers are well tolerated and considered safe when used as directed. Because they are non-hormonal, they are often preferred by women who either cannot or choose not to use hormonal treatments.

Side effects are uncommon, but some women may experience mild irritation – usually related to other ingredients in the product rather than the hyaluronic acid itself.

Practical safety tips

When choosing a product, it’s best to:

• Avoid unnecessary additives such as fragrances or parabens
• Choose formulations specifically designed for vaginal use
• Use consistently rather than occasionally

Hyaluronic acid moisturisers can be used long-term to help manage symptoms, but as always, it’s important to speak with your GP or gynaecologist about what’s most appropriate for your individual situation.

When to talk to your doctor

While vaginal dryness is common, it’s important to seek further support if symptoms are persistent, worsening, or impacting your quality of life.

If you experience pain, unusual discharge, or bleeding, it’s important to have this assessed to rule out other causes.

The bottom line

Vaginal dryness is a common, but often under-discussed, part of hormonal change.

Hyaluronic acid offers a non-hormonal, well-tolerated approach that supports hydration, elasticity, and overall tissue comfort. And importantly, it’s backed by a growing body of clinical evidence.

For many women, it becomes a simple, consistent way to feel more comfortable – and more like themselves again.

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About Sarah Gray

Sarah Gray is a registered pharmacist, registered nutritionist, and certified menopause practitioner. She is the founder of The Nutrition Pharmacist and works with women across Australia to navigate perimenopause with practical, evidence-based strategies.

Sarah is also a practitioner partner with Biolae, contributing clinical insights into women’s health and menopause care.

References

• Albalawi NS, et al. (2023). Comparison of the Efficacy of Vaginal Hyaluronic Acid to Estrogen for the Treatment of Vaginal Atrophy in Postmenopausal Women: A Systematic Review. Cureus.
• Australasian Menopause Society. Genitourinary Syndrome of Menopause Information Sheet. https://hub.menopause.org.au/Play?pId=e3cb85a0-2da9-40a0-8974-057ee3b2bf30
• Ilhan G et al. (2021). Clinical Efficacy of Hormonal and Nonhormonal Agents in the Treatment of Vulvovaginal Atrophy. Journal of Menopausal Medicine.
• Nappi RE et al. (2022). Hyaluronic Acid: A Valid Therapeutic Option for Early Management of Genitourinary Syndrome of Menopause in Cancer Survivors? Healthcare (Basel).