Hyaluronic Acid Vaginal Gels and Suppositories: What Trials Show for Dryness

Hyaluronic acid holds water, which is why it’s in face serums and also in many vaginal moisturizers, gels and suppositories sold for menopause dryness. It’s hormone-free, which appeals to many women. Here is what the research shows.

Compared with vaginal estrogen

A head-to-head trial. About 140 postmenopausal women with dryness used either a hyaluronic acid gel or a low-dose estriol cream every 3 days for ten applications.¹

• Dryness improved in about 84% with hyaluronic acid and 89% with estriol, a difference that wasn’t statistically significant.¹
• Itching, burning and pain with sex improved similarly in both groups.¹
• Vaginal pH improved more with estriol.¹

The trial was open-label (women knew which product they used) and short.¹

A systematic review. Five small studies with 335 women found hyaluronic acid performed about as well as vaginal estrogen on tissue thinning, pH, painful sex and cell changes.² The studies measured results differently, so the data couldn’t be combined statistically.² The authors called hyaluronic acid an alternative for women seeking a nonhormonal option.²

For breast and endometrial cancer survivors

In a study of 101 survivors of hormone receptor-positive cancers, many taking aromatase inhibitors, daily use for two weeks then three times a week improved vaginal and vulvar symptoms and sexual function over about six months.³ The authors suggested 3 to 5 times a week may work better for survivors than the 1 to 2 times a week often used in natural menopause.³ There was no comparison group.³ Our article on vaginal estrogen after breast cancer covers the hormonal option.

What to keep in mind

• These were small studies with short follow-up.
• Products vary in hyaluronic acid amount and other ingredients. Check for fragrance or additives that irritate you.
• Moisturizers work over time; lubricants are for sex. Our guide to moisturizers versus lubricants explains the difference, and our lubricant label guide covers ingredients.

Questions to ask

1. Could hyaluronic acid be enough for my symptoms, or would vaginal estrogen work better?
2. How often should I use it?
3. What if it isn’t helping after a couple of months?

Try: “I’d like to try a hormone-free option for dryness first. Is a hyaluronic acid gel reasonable, and how often should I use it?”

Down There, Decoded includes a Down-There Log and a See script for appointments. Use them to rate dryness, itching and comfort weekly so you can tell whether it’s working. Explore the intimate-health playbook.