Improving Your Vulvovaginal Health

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This information explains vulvovaginal (vul-voh-VA-jih-nul) health. It also explains how to keep your vulva and vagina healthy during and after your cancer treatment.

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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:

  • The inner and outer lips of your labia (LAY-bee-uh). The inner lips are called labia minora (MUH-naw-ruh) and the outer lips are 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.
"Figure 1. Your Vulva"

Figure 1. Your vulva

As you get older, your vulva and vagina become drier and less elastic (stretchy). This process can happen sooner for people who have had cancer treatments. It can also happen sooner for people who have had a surgery to lower their risk of getting cancer.

Some people can take the hormone estrogen (ES-truh-jin) to slow down this process. However, it’s not a safe choice for everyone. A hormone is a chemical that helps control how different parts of your body work.

Vaginal (VA-jih-nul) and vulvar (VUL-ver) dryness is a common problem for many people. There are ways to improve this. Below are some suggestions to help you manage vaginal and vulvar dryness and tightness. Talk with your healthcare provider about which ones may work best for you.

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Vaginal and Vulvar Moisturizers

One of the best ways to reduce vaginal and vulvar dryness is to use a moisturizer. Vaginal and vulvar moisturizers help improve tissue quality by increasing moisture and elasticity (movement) in your vagina and vulva. These moisturizers are different from lubricants, which are used during sexual activity.

There are different kinds of vaginal and vulvar moisturizers. One kind is a gel or cream that you put into your vagina with a disposable applicator. This is an applicator shaped like a tampon.

Another kind of moisturizer is a vaginal melt, also called a suppository (suh-PAH-zih-TOR-ee). This is a solid capsule (pill) that you put into your vagina with your fingers. Once the suppository is in your body, it melts and is absorbed.

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.

Here are some examples of vaginal and vulvar moisturizers:

Hydrating moisturizers

Hydrating moisturizers help increase moisture (water) in your vaginal and vulvar tissues. This helps reduce dryness and keep your tissues moist.

  • HYALO GYN®
    • You can put this moisturizer into your vagina with a disposable applicator. You can also put this moisturizer on your vulva.
    • You can buy HYALO GYN online at www.hyalogyn.com
  • Revaree®
    • This moisturizer is a suppository that you put into your vagina with your fingers.
    • You can buy Revaree online at www.hellobonafide.com and use code MSKREV25 at checkout. This code will get you 25% off your first month when you order a monthly subscription of Revaree. This offer is only good for subscriptions of Revaree.
    • If you’re an MSK patient, you can get more coupons for Revaree. For more information, call the Female Sexual Medicine and Women’s Health Program at 646-888-5076.
  • Replens™ Long-Lasting Vaginal Moisturizer
    • You can put this moisturizer into your vagina with a disposable applicator. You can also put this moisturizer on your vulva.
    • 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 with a disposable applicator. You can also put this moisturizer on your vulva.
    • You can buy Good Clean Love at your local pharmacy or from online retailers, such as Amazon and Walmart.

Soothing (natural oil) moisturizers

Soothing moisturizers are natural oils or balms that can help with vaginal and vulvar dryness. They can also help soothe itching or burning. These moisturizers are usually safe to use because they have all-natural ingredients.

  • Carlson® Key–E® Suppositories
    • These are suppositories that you put into your vagina with 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, such as vitamin E or coconut oil
    • You can put natural oils inside or outside of your vagina.
    • You can buy natural oils online, or at your local pharmacy or health food store.
  • Natural oil balms, such as VMAGIC and Vulva Harmony
    • You can put natural oil balms on your vulva.
    • You can buy VMAGIC and Vulva Harmony from online retailers, such as Amazon and Walmart.

Talk with your healthcare provider about which type of moisturizer is best for you. If you have very bad dryness and irritation, a hydrating moisturizer may be better for you.

Never use petroleum jelly (such as Vaseline®) as a moisturizer. It can irritate your vagina and vulva. It can also raise your risk of getting a vaginal infection.

How to use vaginal and vulvar moisturizers

  • Many vaginal moisturizers come with a disposable applicator that you put carefully into your vagina. Some applicators come with the moisturizer already in them. For others, you will need to fill the applicator with the moisturizer. You can put lubricant on the tip of the applicator to make it easier to put into your vagina.
  • You can also use vaginal moisturizers on your vulva, including the inner and outer lips of your labia. Labia are the folds of skin around your vagina (see Figure 1). Put a small amount of moisturizer (about the size of a grape, or ½ of an applicator) on your finger. Then, gently rub the moisturizer into your vaginal opening and onto your labia.
  • To help with symptoms, many people may need to use these moisturizers 3 to 5 times a week. Symptoms can happen during your treatment and when you’re finished with treatment. They can also happen if you’re going through sudden menopause (when your period stops).
  • Vaginal and vulvar moisturizers should be used before you go to bed. This is so the product can be fully absorbed when you’re lying down. If you’re sitting up, standing, or walking, the product can leak out of your vagina.

If you also use vaginal estrogen, do not use it on the same nights you use these moisturizers. For more information about vaginal estrogen, read the “Vaginal Estrogen” section.

Some people wear panty liners or pads while using these 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®. Make sure to put the cream on your vulva before using a panty liner or pad.

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Vaginal Lubricants

Vaginal lubricants are used to add to your natural lubrication (wetness). They help decrease dryness and pain during sexual activity. You can use lubricants to make vaginal insertion or external sexual touch more comfortable and pleasurable.

Vaginal lubricants usually 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
  • Good Clean Love® (organic)
  • Aloe Cadabra®
  • Luvena®
  • AH! YES®
  • Aquagel®
  • Sliquid®
  • Astroglide®
  • K-Y Jelly®
Silicone-based lubricants
  • Pjur®
  • PINK™
  • Astroglide® Silicone
  • Uberlube
Natural oils
  • Almond oil
  • Coconut oil

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®) as a lubricant. It is hard to wash off and can irritate your vagina. It can also 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.

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Vaginal Estrogen

Vaginal estrogen is a hormone medication you can take to keep your vulva and vagina healthy. You can only get vaginal estrogen with a prescription. Talk with your care team to see if this is a safe option for you.

The following medications are different brands of estradiol (es-truh-DY-ol). Estradiol is a kind of vaginal estrogen. Make sure to talk with your healthcare provider or surgeon before using a vaginal estrogen.

  • Yuvafem (Vagifem®)
    • This medication comes in an applicator. Put it 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 medication comes in an oil-based vaginal suppository. Put it 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 medication comes as a vaginal ring. Put the ring into your vagina and push it as far back as you can. You need to remove and replace the ring every 90 days.
  • Estrace®
    • This medication comes as a cream. You put the cream inside your vagina and around your vaginal opening 2 to 3 times a week. Your healthcare provider will teach you how to do this.
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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.

The following is a list of specialty stores in New York City, as well as some national websites. You can buy products from these websites, no matter where you live. You can also search online for other specialty stores near you. MSK does not endorse (support or approve) any of these companies.

New York City specialty stores

National websites

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Female Sexual Medicine and Women’s Health Program

If you would like more information about sexual health, talk with your 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:

  • 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
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Last Updated

Wednesday, February 8, 2023
If you have any questions, contact a member of your care team directly. If you're a patient at MSK and you need to reach a provider after , during the weekend, or on a holiday, call 212-639-2000.
If you have any questions, contact a member of your care team directly. If you're a patient at MSK and you need to reach a provider after , during the weekend, or on a holiday, call 212-639-2000.

For more resources, visit www.mskcc.org/pe to search our virtual library.

Improving Your Vulvovaginal Health - Last updated on February 8, 2023
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