Vaginal dryness while breastfeeding: the oestrogen link

Author: Jessica Lloyd
Senior Vulvovaginal Specialist Naturopath | BHSc(N) | ISSVD, ISSWSH, BSSM, ATMS

Last reviewed: July 7, 2026

Oestrogen runs very high during pregnancy, helping the baby develop and building the milk-ducting system in the breasts. The moment the baby is born, oestrogen plummets to near-menopausal levels, which clears the way for prolactin, the milk-making hormone, to take over.

Prolactin stays high while you’re nursing, and oestrogen tends to stay low for as long as you breastfeed. That low-oestrogen state can bring on some unexpected and unwelcome vaginal and pelvic floor symptoms – dryness, discomfort, low libido and microbiome changes – now increasingly recognised together as the genitourinary syndrome of lactation¹. It’s common, it isn’t a sign anything is wrong, and it usually lifts as you wean and your cycle returns.

Why breastfeeding lowers oestrogen

High prolactin quietens the hormonal signals that would normally drive your ovaries, so oestrogen stays low and periods often don’t return for a while (lactational amenorrhoea)¹.

This is completely normal biology – your body is prioritising milk. But because oestrogen has such a strong effect on vaginal and pelvic tissue, keeping it low for months has knock-on effects worth knowing about.

What low oestrogen does to the vagina and pelvic floor

Low oestrogen can cause a dry vagina, low libido, discomfort or pain during sex, and pelvic floor laxity or weakness, and it may delay the return of normal periods. These changes are very common in breastfeeding women, and they tend to ease once oestrogen recovers¹.

Oestrogen also shapes the vaginal microbiome. It drives glycogen into the vaginal cells, and that glycogen is the main food source for protective lactobacilli².

Lactobacilli are the desirable vaginal bacteria that keep disruptive microbes in check. When oestrogen is low, there’s less glycogen to feed them, their numbers dwindle, and other microbes can move in.

The result can be vaginal dysbiosis, such as bacterial vaginosis (BV) or aerobic vaginitis (AV), with odour, discharge, itching, burning or discomfort – the last thing you need while nursing a new baby.

The pelvic floor can feel a little weaker too, since oestrogen has such a strong effect on this area. Be gentle with your expectations of your body – it’s already doing a lot.

Managing low-oestrogen symptoms while breastfeeding

You don’t have to just put up with it. Most of these symptoms respond well to gentle, low-risk measures, and you can layer a few together.

Moisturisers and lubricants

A regular vaginal moisturiser used a few times a week helps with day-to-day dryness, and a good lubricant makes sex more comfortable. These are the simplest first step and are safe to use while breastfeeding¹.

Natural options with evidence behind them

A couple of plant ingredients have real trial evidence for vaginal dryness and atrophy, and none of them are drugs. Fennel used vaginally can improve the thickness and health of vaginal tissue³ – there’s more detail in our guide to fennel for vaginal dryness. Sea buckthorn oil, taken by mouth, may also support the vaginal lining⁴. These work gently without changing your whole-body hormone levels. Worth knowing: these trials were done in postmenopausal women rather than breastfeeding women, so treat them as promising rather than proven for lactation, and check with your practitioner before using anything vaginally while nursing.

Pelvic floor work

Regular pelvic floor exercises help rebuild strength postpartum, and a pelvic floor physiotherapist is well worth seeing if things feel weak, heavy or uncomfortable. This is outside our scope – we don’t do physical assessments – so a physio is the right person here.

Phytoestrogen foods

Some foods contain phytoestrogens – plant compounds with a mild oestrogen-like effect – such as soy, flaxseed and legumes. They’re far weaker than your own oestrogen – often by a factor of hundreds⁵ – so in a low-oestrogen state they’re a weak top-up at best⁶, but they’re a harmless addition to the plate.

Vaginal oestrogen

If symptoms are stubborn, a doctor may prescribe a low-dose vaginal oestrogen cream. It works locally, with minimal absorption into the bloodstream, and is generally considered compatible with breastfeeding – but it’s a conversation to have with your own practitioner¹.

Look after the microbiome

If you have odour, unusual discharge, itching or burning, it’s worth checking whether the microbiome has tipped into BV or AV rather than assuming it’s just dryness. A comprehensive vaginal microbiome test can show what’s actually going on, and we have specific guidance on treating BV while breastfeeding.

When to see a doctor

Book in with a doctor or come and see us if you have:

Pain during sex that isn’t easing with moisturisers and lubricants
Odour, unusual discharge, itching or burning (possible BV, AV or thrush)
Urinary symptoms or recurrent urinary tract infections
A feeling of heaviness, dragging or bulging in the vagina (possible prolapse)
Any unexpected bleeding

Frequently asked questions

Is vaginal dryness normal while breastfeeding?

Yes. Breastfeeding keeps oestrogen low, and low oestrogen thins and dries the vaginal tissue, so dryness and discomfort with sex are very common while you’re nursing. It’s normal and treatable, and it usually improves as you wean.

Will my oestrogen and periods come back after I stop breastfeeding?

For most people, yes. As feeds drop off and prolactin falls, oestrogen recovers and periods return, usually within a few weeks to a few months. If your periods haven’t come back a few months after weaning, it’s worth getting checked.

Is vaginal oestrogen cream safe while breastfeeding?

Low-dose vaginal oestrogen works locally and is absorbed into the bloodstream only in tiny amounts, so it’s generally considered compatible with breastfeeding¹. As with any medication while nursing, check with your own doctor first.

Can breastfeeding cause BV or thrush?

Indirectly, yes. Low oestrogen means less glycogen to feed protective lactobacilli, which can let disruptive bacteria take over and tip the balance towards BV or AV. If you notice odour, discharge or itching, get it checked rather than assuming it’s just dryness.

Talk to your practitioner about your symptoms and the right approach for you. You’re welcome to book an appointment to work through it.

This article is general information and not a substitute for personalised medical advice. If your symptoms are severe, not settling, or worrying you, please see an experienced practitioner.