Vaginal mucosal atrophy and vaginal dryness are signs of estrogen decline.

The most common cause of vaginal dryness is declining estrogen production, which leads to thinning and drying of the vaginal wall. Other factors that contribute to vaginal dryness include reduced muscle tone and the longer time needed for sexual arousal that is so common in perimenopause.

Emotional stress can cause vaginal dryness. Depression or being under tremendous amounts of stress contribute to the issue.

Also, vaginal dryness can be a side effect of underlying medical conditions, so it’s a good idea to check with your doctor for any underlying conditions.