Can stress cause vaginal dryness? How stress affects your vulva

Stress shows up in the body in lots of ways. For some of us, the vulva is one of them. You might feel dry or tight when life gets busy. Or you might be more sensitive to heat, rubbing or washing products.

The research is thin. Stress doesn’t seem to cause dryness directly. But there are reasons why it can make things worse.

Can stress cause dryness during sex?

When you're aroused, more blood flows to the vagina. That brings more fluid, which is your natural lubrication. Stress gets in the way.

A small US study in 2013 found that women under long-term stress had lower genital arousal. They also reported more problems with lubrication. Being distracted seemed to matter most. It's hard to feel aroused when your mind is on your to-do list.

Can stress affect your hormones?

Sometimes. Stress is a common cause of late or missed periods. If you stop ovulating, your oestrogen stays lower, and low oestrogen causes dryness. We explain how in Low oestrogen symptoms: why your vulva and vagina get dry.

If you're in your 40s, think about perimenopause too. It often arrives at a busy, stressful time of life. So dryness that seems to be down to stress may be your hormones changing.

Why might your vulva feel drier or sorer when you're stressed?

A tense pelvic floor. Stress can make you clench muscles without noticing. That includes your pelvic floor. NHS physiotherapists list stress as one trigger for an overactive pelvic floor. It can cause pain in the vulva, and pain during or after sex.

Skin flare-ups. Stress is a well-known trigger for eczema flares. The vulva is skin, so it can get eczema too. Stress can also make itching feel worse. And scratching makes the skin sorer.

Sweat and rushed habits. Stress can make you sweat more. Damp skin rubs and gets irritated more easily. When we're busy, we may also grab whatever wash is to hand, or stay in damp clothes for longer.

Poor sleep. Stress often means bad nights. Skin does a lot of its repair while you sleep. So a run of poor sleep may leave it less resilient.

What can help?

None of this treats dryness. But it can help sensitive skin settle.

Keep washing simple. Use water, or an emollient instead of soap, once a day at most. Skip anything perfumed.

Keep moving. It's good for your circulation, and stretching can help a tight pelvic floor relax. If you think your pelvic floor is tense, ask your GP about seeing a pelvic health physiotherapist. Squeezing exercises aren't always the answer. A tense pelvic floor often needs to learn to let go.

Drink enough water. It helps keep the moist linings of your body moist.

For sex, give yourself time to get aroused. Use a lubricant if you need one.

Short pauses, slow breathing and a regular bedtime can help your nervous system calm down.

When should I see a GP?

See a GP if dryness won't go away, hurts, or comes with splitting or burning. Go too if your periods stop or change. Stress may play a part, but it's rarely the only cause. Your GP can check for menopause, medicines, infections and skin conditions. For other causes, see Why is my vulva dry, itchy or sore? and Can medication cause vaginal dryness?. 

In short

Stress doesn't directly cause vulval dryness, but it can dampen arousal, tense your pelvic floor, flare your skin and upset your periods. Keep washing simple and keep moving. Use lubricant for sex, and get enough sleep.

References

Hamilton LD and Meston CM, "Chronic stress and sexual function in women," Journal of Sexual Medicine (2013) https://pmc.ncbi.nlm.nih.gov/articles/PMC4199300/

NHS, "Missed or late periods" https://www.nhs.uk/conditions/missed-or-late-periods/

NHS Fife, "Overactive pelvic floor muscles" https://www.nhsfife.org/services/all-services/patient-advice/overactive-pelvic-floor-muscles/