How do COCs (combined oral contraceptive pills) cause vaginal dryness?Updated 3 months ago

Combined oral contraceptive pills (also known as COCs) work by introducing extra estrogen and progesterone to your system. These hormones work to stop ovulation, thin the lining of your uterus, and thicken your cervical mucus in order to prevent pregnancy. The extra hormones can provide other benefits as well, like making your periods more regular and lighter, nixing period cramps, and improving hormonal acne. 

However, some research has shown that this form of hormonal contraception might cause vaginal dryness in some women. This could feel like dryness, itching, burning, stinging, and even pain or bleeding down there—which can make sex painful and unpleasant. 

This might be surprising to hear. After all, don’t people in menopause use hormones like estrogen to help with vaginal dryness? Why are they potentially causing dryness now? Experts are still working on understanding the why, but the likely culprit is that COCs can lower your body’s testosterone levels and increase the levels of another compound called sex hormone-binding globulin (SHBG). 

Why does that matter? Well, testosterone helps keep vaginal tissue strong and thick, and also supports various processes that help with arousal and lubrication. With less testosterone in your body—and more of SHBG, which binds to sex hormones so they can’t be used—it may become harder for your vaginal tissues to make the lubrication they need. (In other words, that dry feeling!)

To be clear, not everyone will deal with vaginal dryness while on The Pill. But if you experience these symptoms, they unfortunately can persist the entire time you take a combined oral contraceptive—and even in some cases, last long after you stop taking the Pill.

Vaginal dryness can be majorly uncomfortable and disruptive to your day-to-day life—and the last thing any of us wants is for people to just put up with pain when there are great solutions available. You can learn more about vaginal dryness caused by COCs here and view all the products we recommend for vaginal health here.