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My group chat with the girls has a new name. It happened one night when a few of us were deep in discussion about — what else — the state of our bodies. Someone made the joke that we talk incessantly about our most “intimate parts.” As the health coach in the group, I responded, “Well, at least we all know what a vulva is now.” We laughed and promptly changed the name of our WhatsApp group to The Vulva Files.
“Thankfully the critical conversation about women’s health is no longer relegated only to private DMs.”
Thankfully, the critical conversation about women’s health is no longer relegated only to private DMs. Our most vulnerable experiences are finally seeing the light of day and even reflecting back at us from the small and big screen. And, it’s about time.
On a recent episode of “Your Friends and Neighbors,” Amanda Peet’s character Mel (50) confides in Coop’s sister (40) that she finds sex challenging during menopause. What she’s alluding to is the vaginal dryness that makes sex uncomfortable. She’s handed a tube of lube to alleviate the situation, which is a great place to start, but actually just the beginning.
What I’ve noticed is that more women of different generations are sharing their stories, advice, and support with each other. It’s a sisterhood created out of kindness and necessity. I think we have the menopause movement to thank for this intergenerational dialogue, at least in part. Over the past few years, there’s been a big cultural shift that catapulted hormones, libido, and mental health from the margins of wellness into the mainstream. This momentum has given women a kind of collective green light to finally stop whispering.
“What I’ve noticed is that more women of different generations are sharing their stories, advice, and support with each other. It’s a sisterhood created out of kindness and necessity.”
It has helped that Hollywood heavyweights like Drew Barrymore, Naomi Watts, and Halle Berry shared their personal menopausal stories off-screen, encouraging all of us to do the same. And the topics of the moment? Intimate health. Vulvas and vaginas. Dryness, discomfort, pleasure, pain, and everything in between.
Our hormones fluctuate throughout our entire lifetime, from puberty to post-menopause, and so does the health of our most intimate tissue. Which brings me to the question that sparked this essay: Do we actually need an intimate care routine? Or is the wellness industry just finding a new, uncharted frontier to sell us more things?
The answer, I’ve learned, is more important and nuanced than I expected.
But, first, an anatomy lesson
Before we talk about care, we need to talk about anatomy. And I say this as someone who spent the better part of four decades using the word “vagina” as a catch-all for everything down there. Spoiler, it is not.
“I say this as someone who spent the better part of four decades using the word “vagina” as a catch-all for everything down there. Spoiler, it is not.”
The vulva is the collective term for the external genitalia, which includes the labia majora, labia minora, clitoris (which, for the record, is much bigger than the small external nub we were taught about — it’s a wishbone-shaped internal structure that extends beneath the surface), urethral opening, and vaginal opening.
The vagina is the internal canal connecting the vulva to the cervix and uterus.
Why does this distinction matter for a skincare conversation? Because these two structures behave differently, age differently, and respond to different kinds of care.
The vagina is lined with mucosal tissue, similar to the inside of your mouth. It is self-cleaning, maintains its own pH microbiome, and microbiome balance. In fact, most of the “intimate hygiene” products on the market are unnecessary at best and disruptive at worst.
The vulva, on the other hand, is external skin. It’s exposed to friction, moisture, clothing, products, and hormonal fluctuation. And just like any other skin on our bodies, it benefits from attention and care.
Knowing the difference is the beginning of knowing what to actually do.
Hormones affect everything
We’ve been led to believe that estrogen is only a reproductive hormone, but actually, it plays a significant ongoing role in maintaining vulvovaginal tissue. Estrogen keeps it lubricated, elastic, and well-supplied with blood flow. When estrogen starts to decline during perimenopause (or drops dramatically during post-partum), that tissue starts to change.
“We’ve been led to believe that estrogen is only a reproductive hormone but actually it plays a significant ongoing role in maintaining vulvovaginal tissue.”
I reached out to my colleague Dr. Sonia Singla, a menopause expert, primary care physician, and founder of The Marigold Center, a holistic women’s health practice in Los Angeles, for some clinical insight.
“As we move through midlife, declining estrogen can lead to noticeable changes in vulvovaginal tissue — things like dryness, thinning, and increased sensitivity,” says Dr. Sonia Singla. “Some women also experience discomfort with intimacy or more frequent urinary symptoms. These shifts are incredibly common — but they’re often under-discussed, and importantly, they’re very treatable.”
The medical term for this cluster of changes is Genitourinary Syndrome of Menopause, or GSM. It encompasses the effects of declining estrogen not just on the vagina, but on the vulva and urinary tract as well. Symptoms like thinning tissues, reduced lubrication, increased susceptibility to infections, and changes like urgency or recurrent UTIs are common.
According to the NIH, approximately 50% of women experience some form of GSM. And yet most don’t seek treatment because they’ve been told that it’s just part of aging. Thanks to the power of “the sisterhood,” women are no longer willing to accept this answer, demanding both answers and treatment to improve their quality of life.
“Approximately 50% of women experience some form of GSM. And yet most don’t seek treatment because they’ve been told that it’s just part of aging.”
Dr. Singla also brings an interesting perspective beyond the purely clinical. “From an Ayurvedic standpoint, this phase of life is associated with an increase in Vata, which is linked to dryness and depletion in the body. In modern terms, we’re talking about declining estrogen — but both systems are describing a similar shift. That’s why practices that restore moisture, nourishment, and circulation become so important during this time.”
“The changes affect all women to varying degrees,” she adds, “so the earlier we get ahead of them, the less problematic the symptoms we’ll need to endure.”
It’s not just a midlife crisis
I’d like to say this again, because it bears repeating that intimate discomfort is not exclusively an issue affecting women in menopause.
“Intimate discomfort is not exclusively an issue affecting women in menopause.”
There are many life events and treatments that can impact our hormones and lead to dryness, irritation, and pain:
- Oral contraceptives suppress estrogen and testosterone, reducing natural lubrication
- Pregnancy and postpartum can shift hormones in a dramatic way
- Antidepressants, antihistamines, and other common medications may cause dryness
- Cancer treatments (chemotherapy and hormone suppression meds) can accelerate vaginal atrophy significantly
- Dehydration and alcohol use can affect lubrication
- Laser hair removal and waxing can irritate and compromise vulvar skin
So, do we need a routine?
Skin is skin, no matter where it is. We moisturize our faces because skin loses elasticity, gets irritated, and benefits from consistent hydration. Vulvovaginal tissue is even more delicate and susceptible to hormonal fluctuation, which can cause symptoms that disrupt our quality of life.
The longer answer is that not all intimate wellness products are worth your money or your trust. The increase in awareness has caused the market to explode, which means there are lots of products to consider and vet carefully.
“The longer answer is that not all intimate wellness products are worth your money or your trust.”
What you want to avoid:
- Products such as fragranced soaps, wipes, or cleansers near the vaginal opening — the vagina is self-cleaning, and fragrance disrupts its pH
- Treatments that “tighten,” “detoxify,” or “rejuvenate” without credible clinical backing and licensed practitioners
What actually works? There are a few categories of topical products, prescriptions, and tools that are promising.
Your intimate care toolkit
Vulvar moisturizers
Think of this as the equivalent of a daily face moisturizer — applied externally to the labia and surrounding tissue to restore the skin barrier, reduce irritation, and maintain hydration. Look for hormone-free formulas with ingredients you’d recognize from quality skincare: hyaluronic acid, ceramides, peptides, vitamin E, and shea butter. An elegant, science-backed product is Plum Vagiceuticals Moisturizing Serum.
Vaginal moisturizers
These are internal, hormone-free suppositories or creams used every few days to maintain hydration and elasticity in the vaginal walls — not just before sex, but as an ongoing part of tissue health. Bonafide Revaree is a popular over-the-counter option and appropriate for women at any hormonal stage experiencing internal dryness.
Lubricants
Lube has a different purpose than a moisturizer. As a tool for comfort and pleasure, it’s designed to reduce friction and protect skin during sexual activity. Research cited by Dr. Emily Morse, host of “Sex with Emily,” suggests women are significantly more likely to experience orgasm when using lube. For water-based or silicone options, Maude Shine Aloe is hypoallergenic and fragrance-free.
The Explorer by Elixir Play
Co-designed with Dr. Kelly Casperson, MD, a board-certified urologist and pelvic health expert, The Explorer is a new, first-of-its-kind vulvar vibrator designed to increase blood flow, support tissue health, and enhance pleasurable sensation. It’s external-only, dual-sided, and particularly well-suited for menopausal women navigating atrophy, dryness, or pain.
Vaginal estrogen (prescription)
For women experiencing GSM, vaginal estrogen remains the gold standard. Available as a cream, suppository, or vaginal ring, it works locally — restoring estrogen to vulvovaginal tissue without significantly affecting systemic hormone levels, making it safe for most women. Vaginal estrogen requires a prescription from your OB-GYN or urologist and is increasingly available through telehealth platforms.
Emsella chair (clinician-provided)
The Emsella chair is a non-invasive treatment that strengthens the pelvic floor and improves bladder control by delivering thousands of muscle contractions in one fully-clothed session.
“Pelvic floor therapies like the Emsella can help with strength, bladder symptoms, and increased blood flow. This is a complementary tool that can enhance results, but it doesn’t replace foundational care.”
Your body, your routine
Ultimately, it’s up to you whether you choose to use any of these products. Think of the women’s wellness market and social media as a place for education and support. It’s encouraging that we can now name these issues and talk about them without embarrassment or shame.
“Think of the women’s wellness market and social media as a place for education and support.”
“The biggest shift I’m seeing is awareness,” says Dr. Singla. “Women are starting to realize that discomfort or dryness isn’t something they have to quietly tolerate. When we talk about it openly, we create space for better care, better solutions, and a much better quality of life. Midlife isn’t the beginning of decline — it’s a transition that deserves support and rebuilding, not silence.”
Where to start
I tell all my private clients, if you’re curious about an intimate care routine as part of your overall wellness, you can start your journey in small ways and customize to your changing needs as you go.
“You can start your journey in small ways and customize to your changing needs as you go.”
Look. There’s a growing movement encouraging women to actually observe their own vulvas — with a hand mirror, in good light. Most of us never have. Familiarity with your own anatomy makes it infinitely easier to notice when something changes.
Moisturize. If you experience any external dryness or irritation, a vulvar moisturizer used regularly is a simple, easy starting point. Treat it like any other skincare step.
Add lube. Remove the stigma. Use it for comfort and pleasure, regardless of age or hormonal status. Pleasure awaits!
Explore. If reconnecting with your body feels like something you need, The Explorer offers a gentle, clinically-informed place to start. A little extra blood flow helps everything.
Talk to your doctor. If you’re experiencing pain with sex, recurring UTIs, significant dryness, or urinary urgency, these are very treatable. Ask specifically about GSM. Ask about vaginal estrogen.
Don’t wait. The earlier you address these shifts, the better the outcomes. As Dr. Singla puts it: The goal is to get ahead of the changes before the symptoms become the story.
“The real upgrade to your health will never be about a serum or a device. It’s the decision to pay attention to what your body needs.”
Just remember that our incredible bodies change throughout our entire lives — with hormones, age, medication, stress, and time. The tissue of our vulvas and vaginas is no exception. Treating intimate care as a legitimate part of a wellness routine isn’t indulgent. It’s simply extending the same health intelligence we’ve already applied everywhere else.
The real upgrade to your health will never be about a serum or a device. It’s the decision to pay attention to what your body needs — to understand your anatomy and biological changes, and to refuse to accept anything less than the life you deserve.
Discuss this in your own group chat, but The Vulva Files wholeheartedly agrees.
Celia Chen is a certified health optimization coach, brand consultant and founder of Chenessa, an advisory that offers private coaching, and corporate workshops on menopause, metabolism, and longevity. Follow her on Substack and Instagram for more wellness insights.
