In the years prior to menopause, women’s bodies naturally maintain moisture and lubrication in the vagina. The vaginal wall is hydrated and tissue lining is intact, making sex comfortable and pleasurable while providing an optimal environment for reproduction. As women approach menopause, estrogen production declines. This shift causes a reduction in blood flow to the vagina, leading to thin and dry vaginal tissue. In some cases the tissue depletes significantly, leaving the vagina prone to inflammation and persistent discomfort. Voila: Vaginal dryness!