NICE says women with vaginal dryness should also be advised that non-medicinal moisturisers and lubricants can be used alone or in addition to vaginal oestrogen. Several of these can be prescribed on the NHS under Part IX-A (Appliances) of the Drug Tariff for England and Wales, and Part 3 of the Scottish Drug Tariff. Creams may have the edge over gels in terms of efficacy and tolerability. Osmolality and pH of the preparation may also be a consideration.^{17,24,25,26,27}

Hyaluronic acid has been compared to hormonal vaginal treatment and may be a suitable alternative for some women. Indeed, studies have shown a hormone-free vaginal moisturising cream to be non-inferior to a vaginal estriol (0.1%) cream. The non-drug cream showed significant improvements in reported impact on quality of life and in reducing dyspareunia in line with the hormonal cream for women with mild to moderate symptoms of vaginal dryness. However, women with severe symptoms had a greater benefit from the estriol cream.^6,28

General advice should include avoiding moisturisers or similar types of products not intended for vaginal use. Petroleum jelly could cause an infection. Perfumed soaps, washes and douches should also be avoided in and around the vagina.¹²

Water-based lubricants can also be recommended before sex and trying to enjoy more foreplay so that there is greater sexual arousal may help improve lubrication.