Nobody likes to think about vaginal dryness, let alone talk about it, let alone experience it. You can experience vaginal dryness at any point in life, but it’s especially common during and after menopause. In fact, according to Harvard Medicine, healthcare providers estimate over half of post-menopausal women suffer from vaginal dryness — but so many of them don’t get treatment for it. In fact, the number is likely higher since many likely experience this, but don’t report it. Some of us just assume that there is no treatment — this is just life after menopause. Well, we have good news: that couldn’t be further from the truth.
“Vaginal dryness is common and very treatable,” Dr. Somi Javaid, an OB/GYN and founder of HerMD, tells SheKnows. Your treatment options range from lifestyle changes to prescription and over-the-counter medications. “A successful treatment plan,” Dr. Javaid explains, “involves a curated approach.”
Estrogen creams and vaginal tablets are popular options, but they’re far from the only option for managing vaginal dryness. If you prefer a hormone-free treatment, we’re here to talk about one that doctors love: Bonafide’s Revaree and Revaree Plus.
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Vaginal Dryness: Why It Happens
For those of us in menopause, vaginal dryness—a generalized and nonmedical term often used to describe the many vaginal symptoms caused by low estrogen due to menopause, according to OB/GYN Dr. Alyssa Dweck, Chief Medical Officer at Bonafide—occurs due to hormonal changes. “The ovaries (are) not producing much estrogen any longer, and that leads to less blood flow in the vagina and less natural lubrication,” Dr. Dweck tells Flow Space. “Similarly, in perimenopause, those estrogen levels are quite variable, and when they are low, dryness can ensue.”
But vaginal dryness doesn’t just happen during menopause or perimenopause. If you’re lactating, you might notice a decrease in vaginal moisture, which is also due to hormone changes. “Typically, one does not resume ovulating and menstruating when exclusively breastfeeding,” Dr. Dweck explains. “This results in a very low estrogen environment similar to menopause, and can lead to similar changes in the vagina.”
Prescription medications and over-the-counter products can also contribute to and possibly cause vaginal dryness. This can include hormonal birth control, medications used to treat fibroids or endometriosis, cancer treatments, and even chronic antihistamine use for those who have allergies. “Those antihistamines don’t only dry up your nasal passages, but may have an effect on vaginal moisture as well,” Dr. Dweck explains.
When we talk about vaginal dryness, know that one might experience a range of symptoms. “Some people will feel itchy,” Dr. Dweck says. “Some will have discharge, itching, irritation and sensitivity. I have patients who will tell me just wearing tight jeans or workout clothes can be uncomfortable because this very delicate skin is being chaffed, and of course, intimacy can be incredibly uncomfortable.”
Finding Relief From Vaginal Dryness
Finding relief from vaginal dryness starts with having a candid conversation with your doctor. “The first hurdle is to actually bring it up to your doctor and discuss your specific symptoms and concerns; many women are embarrassed, ashamed or just uncomfortable even mentioning this subject matter,” Dr. Dweck says. Her advice: know that there’s nothing to be embarrassed about, because this is such a common experience. If you’re in menopause, your doctor might, and frankly should, be the one to bring it up.
After discussing your symptoms and possible causes, your doctor will suggest potential solutions. “First, consider adequate hydration,” Dr. Dweck says. “Be mindful of product ingredients or garment materials which might cause irritation, sensitivity and dryness. Most importantly, we speak about treatment options.”
The “gold standard” treatment is vaginal estrogen, which can be used in the form of a cream, a vaginal tablet, or a vaginal ring, to provide estrogen locally to the vagina. This helps the tissue become more elastic and comfortable, Dr. Dweck explains. Another option, she says, is a hormone-free vaginal moisturizer, which is a wonderful and often preferred option for women who can’t or don’t feel comfortable taking estrogen. These moisturizers use ingredients like hyaluronic acid (more on that in a bit) to provide increased moisture and ease vaginal dryness. Other treatment options might include CO2 laser or radiofrequency (RF) treatments, which both claim to stimulate the production of collagen in the vagina to alleviate symptoms.
The key difference between using hormones or procedures like CO2 or RF, and over-the-counter moisturizers and lubricants, is that the former “actually changes the anatomy by increasing the thickness and elasticity of the vaginal walls,” Dr. Javaid explains. “Lubricants and moisturizers can [relieve] the dryness, but do not change the anatomy.”
What Is Bonafide Revaree?
Bonafide Revaree falls under the category of over-the-counter vaginal moisturizers and lubricants. It’s a vaginal insert that utilizes hyaluronic acid to provide relief from vaginal dryness and painful sex, without any hormones involved. You simply place one insert in your vagina two-to-three times a week when you’re lying down, ready to go to sleep, and it dissolves within about 30 minutes.
And yes, Revaree uses the same hyaluronic acid you’re always looking for in facial creams and moisturizers. “It provides incredible vaginal moisture, because hyaluronic acid will hold on to about a thousand times its weight in water,” Dr. Dweck explains. Revaree contains 5 milligrams of hyaluronic acid, while Revaree Plus (an extra-strength version) contains 10 milligrams along with sweet almond oil, which helps to “seal in the moisture that is absorbed by the hyaluronic acid,” says Dr. Dweck, who recommends using Revaree or Revaree Plus twice a week.
Users report significant improvement with Revaree. “Women report they wished they had known about Revaree earlier since they’ve really been suffering,” says Dr. Dweck. “They feel relieved… many state that sex doesn’t feel like sandpaper anymore and that day to day comfort is improved.”
Addressing vaginal dryness can make a positive impact on one’s sexual life, too. “Many of my patients feel really disconnected from their partners if they can’t engage intimately, because they’re so afraid of the pain,” Dr. Dweck says. “I think women feel so much more confident once they initiate intervention for their dryness… Sex is much more comfortable.”
Bonafide, whose products are well-studied in clinical research, supported a clinical trial at NYU Grossman School of Medicine that found that “vaginally inserted hyaluronic acid, the key ingredient in Revaree, has effects comparable and not inferior to estrogen cream” when it comes to vaginal dryness. “For this reason, Revaree can be confidently recommended and used as a safe and effective alternative or adjunct to hormonal treatments,”as Dr. Dweck says .“Revaree is one of the products that I recommend in addition to hormones or instead of for those patients who opt out of hormone therapy,” says Dr. Javaid.
How Long Does It Take for Revaree To Work?
It’s recommended to use Revaree or Revaree Plus every two to three nights, or about twice a week — or as directed by your doctor. At that cadence, you should see relief from vaginal dryness within nine days, Dr. Dweck says. After that, she recommends using it regularly to continue to see relief.
Can You Buy Revaree Over the Counter?
Both Revaree or Revaree Plus are over-the-counter, which means you can get them without a prescription through Bonafide’s website — either a three-month or one-month supply. Dr. Dweck recommends talking to your OB/GYN to confirm the cause of your dryness. “It’s very reasonable to be evaluated to confirm no infection or other cause that may be leading to discomfort,” she explains.
Vaginal dryness is definitely unpleasant (one of many menopause symptoms we could say that about), but you’re not alone if you’re dealing with it — and you don’t have to keep suffering. “Vaginal dryness is common and very treatable,” Dr. Javaid says. And, Dr. Dweck adds, “the stigma is fading around this particular condition”. “The conversation is getting much more vocal and acceptable.” In other words, don’t be afraid to look into your treatment options and talk to your doctor about Revaree and other solutions to vaginal dryness.