This information explains vulvovaginal (vul-voh-VA-jih-nul) health. It also explains how to keep your vulva (VUL-vuh) and vagina (vuh-JY-nuh) healthy during and after your cancer treatment.
About your vulvovaginal health
Vulvovaginal health is the health of your vulva and vagina. Vulva is another name for your external sex organs. These are genitals on the outside of your body (see Figure 1).
The parts of your vulva are:
- Your labia (LAY-bee-uh). Labia are the folds of skin around your vagina. Your labia are made up of inner lips called labia minora (MUH-naw-ruh) and outer lips called labia majora (MUH-jaw-ruh).
- Your clitoris (klit-OOR-us).
- The opening of your vagina.
- The opening of your urethra (yoo-REE-thruh). The urethra is a tube that carries urine (pee) out of your body.
- The vestibule (VEH-stih-byool), which starts just below your clitoris and ends at the labia minora. The vestibule surrounds the opening of your vagina and urethra.
As you get older, your vagina and vulva become drier and less elastic (stretchy). This can happen earlier if you’ve had cancer treatment or had surgery to lower your risk of getting cancer. Some people take the hormone estrogen (ES-truh-jin) to help reduce vaginal (VA-jih-nul) and vulvar (VUL-ver) dryness and tightness. But taking estrogen isn’t safe for everyone.
Vaginal and vulvar dryness is a common problem for many people. There are ways to make this better. In this resource, we offer suggestions to help you manage vaginal and vulvar dryness and tightness. Talk with your healthcare provider about which ones may work best for you.
Vaginal and vulvar moisturizers
One of the best ways to reduce vaginal and vulvar dryness and tightness is to use a moisturizer. Vaginal and vulvar moisturizers help your vaginal and vulvar tissues stay soft and elastic.
These moisturizers come in a few forms, such as:
- A gel or cream: You put the gel or cream into your vagina using an applicator shaped like a tampon.
- A suppository (suh-PAH-zih-TOR-ee): This is a small capsule (pill) you put into your vagina with your fingers. It melts inside your body and is absorbed. Suppositories are also called vaginal melts.
You can use vaginal and vulvar moisturizers at any time, not just before or during sexual activity. Use them 3 to 5 times a week to help with your overall vaginal health and comfort.
Over-the-counter vaginal and vulvar moisturizers do not have any hormones in them. You can buy them online or at your local pharmacy without a prescription.
Never use petroleum jelly (such as Vaseline®) or a product made of 100% petrolatum as a moisturizer. It can irritate your vagina and vulva. It also can raise your risk of getting a vaginal infection.
Hydrating vaginal and vulvar moisturizers
Hydrating moisturizers can help keep your vaginal and vulvar tissues moist.
HYALO GYN®
You can put this moisturizer into your vagina using a disposable applicator. You also can put this moisturizer on your vulva with your fingers.
You can buy HYALO GYN online at www.hyalogyn.com. Use code MSK20 at checkout. This code will get you 20% off your first month when you order a monthly subscription to HYALO GYN. This offer is only good for subscriptions of HYALO GYN.
Revaree®
This moisturizer is a suppository that you put into your vagina with your fingers.
You can buy Revaree online at www.hellobonafide.com. Use code MSKREV25 at checkout. This code will get you 25% off your first month when you order a monthly subscription to Revaree. This offer is only good for subscriptions of Revaree.
If you’re an MSK patient, you can get an extra discount for Revaree. Call the Female Sexual Medicine and Women’s Health Program at 646-888-5076 for more information.
Replens™ Long-Lasting Vaginal Moisturizer
You can put this moisturizer into your vagina using a disposable applicator. You also can put this moisturizer on your vulva with your fingers.
You can buy Replens at your local pharmacy or from online retailers, such as Amazon and Walmart.
Good Clean Love BioNourish® Ultra Moisturizing Vaginal Gel with Hyaluronic Acid
You can put this moisturizer into your vagina using a disposable applicator. You also can put this moisturizer on your vulva with your fingers.
You can buy Good Clean Love at your local pharmacy or from online retailers, such as Amazon and Walmart.
Via™ by Solv Wellness®
You can put this moisturizer into your vagina with a reusable silicone applicator. You also can put this moisturizer on your vulva with your fingers.
You can buy Via online at www.solvwellness.com.
If you’re an MSK patient, you can get special discounts when you sign up for a subscription to Via. Call the Solv Wellness Customer Care Team at 877-421-7160 to learn more.
When you call, tell them:
- You’re a patient in active treatment at MSK.
- The name of your primary MSK oncologist (cancer doctor who prescribes your cancer treatment) or MSK sexual medicine provider.
Non-hydrating (soothing) vaginal and vulvar moisturizers
Soothing moisturizers are natural oils or balms that can help with vaginal and vulvar dryness. They also can help soothe itching or burning. These moisturizers are often safe to use because they have all-natural ingredients.
Carlson® Key–E® Suppositories
These are suppositories that you put into your vagina using a disposable applicator. They work best if you use them at bedtime.
You can buy Carlson Key-E suppositories online at www.carlsonlabs.com.
Natural oils
You can put natural oils inside or outside of your vagina. Examples of natural oils are vitamin E and coconut oil.
You can buy natural oils online, or at your local pharmacy or health food store.
Natural oil balms
You can put natural oil balms on your vulva. Examples of natural oil balms are VMAGIC and Vulva Harmony.
You can buy natural oil balms online, or at your local pharmacy or health food store.
Talk with your healthcare provider about which kind of moisturizer is best for you. If you have lots of dryness and irritation, a hydrating moisturizer may be better than a soothing moisturizer.
How to use vaginal and vulvar moisturizers
- If your moisturizer comes as a suppository, gently push the capsule into your vagina with your fingers.
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If your moisturizer comes with an applicator, use it the same way you would a tampon.
- Some applicators come with the moisturizer already in them. For others, you may need to fill the applicator with moisturizer first.
- If you want, you can put lubricant on the tip of the applicator. This makes it easier to put it into your vagina.
- Put the applicator carefully into your vagina and press the plunger to release the product. Take out the applicator. If it’s a disposable applicator, throw it away. If it’s a reusable applicator, clean it with warm, soapy water.
- You can put vaginal moisturizers on your vulva, including the inner and outer lips of your labia. Put a small amount of moisturizer (about the size of a grape, or ½ to 1 full applicator) on your finger. Gently rub the moisturizer into your vaginal opening and onto your labia.
- Many people use vaginal and vulvar moisturizers 3 to 5 times a week to help with their symptoms. Symptoms can happen during your cancer treatment and when you’re done with treatment. They also can happen if you’re going through sudden menopause (when your period stops).
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Use vaginal and vulvar moisturizers at bedtime. When you’re lying down, your body can absorb the product better. If you’re sitting up, standing, or walking, it may leak out of your vagina.
- If you use vaginal estrogen, do not use it on the same nights you use vaginal or vulvar moisturizer. To learn more about vaginal estrogen, read the “Vaginal estrogen” section.
- Some people wear panty liners or pads while using vaginal and vulvar moisturizers, or for urinary incontinence (leaking urine). Wearing panty liners or pads can make your vulva dry. To help seal in moisture and protect your skin, use a cream such as Aquaphor®, Balmex®, or Desitin®. These creams have some petrolatum in them but are safe to use. Make sure to put the cream on your vulva before using a panty liner or pad.
Vaginal lubricants
Vaginal lubricants add to your natural lubrication (wetness). They help reduce dryness and pain during sexual activity. You can use lubricants to make vaginal insertion or external sexual touch more comfortable and pleasurable (enjoyable).
Vaginal lubricants often come in a liquid or gel form. You can buy them online or at your local pharmacy without a prescription.
Here are some examples of vaginal lubricants:
| Water-based lubricants | |
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*If you have sensitive skin and this product is irritating, choose another product from the list. |
| Silicone-based lubricants | |
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| Natural oils | |
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Some lubricants and lubricant ingredients can be irritating. Do not use these if they irritate your vagina:
- Semen (ejaculatory fluid).
- Saliva (spit).
- Colored, flavored, or warming lubricants.
- Certain lubricant ingredients, such as chlorhexidine, glycerin, and propylene glycol.
Never use petroleum jelly (such as Vaseline®) or a product made of 100% petrolatum as a lubricant. It’s hard to wash off and can irritate your vagina. It also can raise your risk of getting a vaginal infection.
If you’re using a latex condom, always use a water-based or silicone-based lubricant. Do not use an oil-based lubricant. It can damage the latex condom and break it.
How to use vaginal lubricants
Put the lubricant around the opening of your vagina. Then, put the lubricant on any object that’s being put into or near your vagina. This can be an applicator, dilator, finger, vibrator, sex toy, or your partner’s penis. Make sure to put the lubricant on the object before it goes into your vagina.
Vaginal estrogen
Vaginal estrogen is a hormone medicine you can take to keep your vulva and vagina healthy. You can only get vaginal estrogen with a prescription from your healthcare provider. Talk with your care team to see if taking vaginal estrogen is a safe option for you.
The medicines listed below are different forms of estradiol (es-truh-DY-ol). Estradiol is a kind of vaginal estrogen. Your healthcare provider will give you instructions on how to use estradiol.
Yuvafem (Vagifem®)
This medicine comes in an applicator. Put the medicine into your vagina every day at bedtime for 14 days. After 14 days, put it into your vagina 2 times a week at bedtime.
Imvexxy®
This medicine comes as an oil-based vaginal suppository. Put the suppository into your vagina every day at bedtime for 14 days. After 14 days, put it into your vagina 2 times a week at bedtime.
Estring®
This medicine comes as a vaginal ring. Put the ring into your vagina and push it as far back as you can. You need to take out and replace the ring every 90 days.
Estrace®
This medicine comes as a cream. Put the cream inside your vagina and around your vaginal opening 2 to 3 times a week.
Making sexual activities more pleasurable
There are many products you can use to help make sexual activities more pleasurable. Examples are lubricants, lingerie, and sex toys. You can buy these online, over the phone, or from a specialty store.
Below is a list of specialty stores in New York City. If you do not live in or near New York City, you can search online for specialty stores near you.
We’ve also listed some national websites below. You can buy products from these websites no matter where you live.
MSK does not endorse (support or approve) any of the specialty stores or websites listed in this resource.
New York City specialty stores
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Babeland
462 Bergen St. (between 5th and 6th avenues)
Brooklyn, NY 11217
917-776-7312
www.babeland.com -
Lady Konfidential
119 West 57th St. (between 6th and 7th avenues), Suite 1201
New York, NY 10019
212-757-8651
www.ladykonfidential.com -
Please
635 5th Ave. (between 17th and 18th streets)
Brooklyn, NY 11215
718-788-6969
www.pleasenyc.com -
The Pleasure Chest (West Village location)
156 7th Ave. S. (between Charles and Perry streets)
New York, NY 10014
212-242-2158
www.thepleasurechest.com -
The Pleasure Chest (Upper East Side location)
810 Lexington Ave. (between East 62nd and East 63rd streets)
New York, NY 10065
212-355-6909
www.thepleasurechest.com
National websites
Female Sexual Medicine and Women’s Health Program
If you would like more information about sexual health, talk with your MSK healthcare provider. They can refer you to our Female Sexual Medicine & Women's Health Program. You can also reach the program by calling 646-888-5076.
The Female Sexual Medicine and Women’s Health Program offers services at these locations:
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Evelyn H. Lauder Breast Center at MSK
300 E. 66th St. (between 1st and 2nd avenues)
New York, NY 10065 -
Rockefeller Outpatient Pavilion at MSK
160 E. 53rd St. (between Lexington and 3rd avenues)
New York, NY 10022
