Nobody puts this one on the bathroom shelfie. The serum gets its close-up and the gua sha gets its golden hour. The pink light wand that promises to "rejuvenate" you down there goes in the drawer with the spare batteries.

The problem it promises to fix has a clunky name, genitourinary syndrome of menopause. It covers dryness, irritation and sex that has started to sting once estrogen falls. Depending on how it is counted, it affects anywhere from about a quarter to most postmenopausal women. If it has not reached you yet, it may be reaching your mother, who will not bring it up at brunch.

The treatments with the best evidence are the cheapest and least glamorous, so climb this ladder from the bottom and leave the glowing rung for last.

Woman in a silk robe beside a wooden ladder in a blush-toned bedroom, the vaginal dryness treatment ladder

The short answer: Red light therapy for vaginal dryness has only early, clinic-based evidence, and no controlled trial has tested an at-home wand. Canadian and American guidelines put vaginal moisturizers and lubricants first, then low-dose vaginal estrogen. Fractional CO2 laser failed its best sham-controlled trial.

  • SOGC Guideline 422b: moisturizers and lubricants first-line, low-dose vaginal estrogen second, long-term laser experimental
  • JAMA 2021, Sydney: three sessions of CO2 laser were no better than sham at 12 months, on symptoms, quality of life and tissue
  • FDA, July 2018: warning letters to seven makers of energy-based vaginal "rejuvenation" devices after reports of burns and scarring
Rung How sure are we What it costs you
1. Vaginal moisturizer and lubricant Established Pharmacy prices
2. Low-dose vaginal estrogen (or DHEA, or ospemifene) Established A prescription
3. Clinic laser or radiofrequency Unsupported: failed its best trial Thousands of dollars, plus top-ups
4. Red light: clinic probe or at-home wand Emerging in clinics; untested at home Not yet a standard service; the wand is a gamble

Rung one: the pharmacy aisle everyone walks through faster

Two products live in that aisle, and they do different jobs. A vaginal moisturizer is used regularly to keep tissue comfortable, the way a night cream works on your face. A lubricant is for the moment itself.

Woman in a bright pharmacy aisle reading the back of a lubricant bottle, first rung of the vaginal dryness ladder

The Society of Obstetricians and Gynaecologists of Canada puts both on the first rung. The label is where to be fussy. A 2024 practice guide in the British Columbia Medical Journal suggests a water-based lubricant with an osmolality no higher than 320 mOsm/kg and a pH around 4.5. It also says to skip glycerin, parabens, propylene glycol, fragrance and anything that promises "sensation". Treat a tingling lubricant the way you would treat a restaurant that promises an experience.

Viva doesn't sell either one, so hand the bottle to your pharmacist and ask about those two numbers. Pharmacists hear stranger questions before lunch. Give a well-chosen moisturizer and lubricant a few weeks before you decide the bottom rung has failed you.

Rung two: is vaginal estrogen safe?

Plenty of women stall at this rung, because the word estrogen walks into the room carrying two decades of headlines. The Canadian guideline is calm about it. At low doses, it says, clinically significant absorption into the rest of the body does not occur, so you do not need a progestogen alongside it.

Woman in her fifties talking with her doctor about vaginal estrogen in a bright consultation room

It comes as a cream, a small tablet or a soft ring. A 2025 guideline from American urology and urogynecology societies gives it a strong recommendation for dryness, irritation and painful sex. For women with this syndrome who keep getting urinary tract infections, it recommends vaginal estrogen to lower the odds of the next one. Nobody mentions that bonus at the pharmacy counter.

Asking for it takes one sentence at an appointment you were probably due for anyway. If estrogen does not suit you, vaginal DHEA and an oral pill called ospemifene sit on the same rung.

Rung three, the one that snapped

The first crack appeared in July 2018, when the US Food and Drug Administration warned women against energy-based devices sold for vaginal "rejuvenation". It had reports of burns, scarring and recurring pain, and it sent letters to seven device makers. "These products have serious risks and don't have adequate evidence to support their use for these purposes," said Scott Gottlieb, then the commissioner.

The real test came from Sydney three years later. In a trial published in JAMA, postmenopausal women had three sessions of carbon dioxide laser or a sham treatment. Neither they nor the assessors knew which. A year on, symptoms, quality of life and even tissue samples looked no different between the two groups.

Canada's chapter is less flattering. Health Canada licensed its first vaginal energy device in 2015. A 2023 commentary in the CMAJ pointed out that many new devices need no controlled studies before approval. The authors found providers in each of the country's ten most populous cities, quoting thousands of dollars for treatment and upkeep.

The SOGC calls long-term laser use for this purpose experimental, to be offered only inside well-run clinical trials. A laser for vaginal dryness is a research procedure with a retail price.

Rung four: does red light therapy work for vaginal dryness?

Red and near-infrared light, which researchers call photobiomodulation, is a gentler idea. It aims to coax tissue along without wounding it, and the early work deserves a fair hearing.

Pale wooden ladder against a blush-pink wall, the rung-by-rung ladder for vaginal dryness treatment

The best of it is a Brazilian trial published this year in Climacteric. Women over 50 had four weekly sessions of low-level laser through a vaginal probe, or the same routine with the device switched off. The treated group leaked less urine and reported less dryness and burning. Sex was no better. One author lists an affiliation with a light-therapy company, which belongs in the small print.

Side effects so far sound mild. In a French safety study, the most common one was a feeling of warmth, which seems fair for a treatment made of light.

Every one of these sessions happened in a clinic, through a medical probe, at a measured dose. We could not find a controlled trial of any at-home wand, however flattering its pink glow looks in the product photos. The light research is young and clinic-based, and none of it tested the device in your cart.

So book the appointment before you buy the wand. Take one sentence with you: "I have dryness or pain with sex, and I want to talk about moisturizers and local estrogen." Your family doctor, a nurse practitioner or a menopause clinic will have heard it before. It takes less time to say than this paragraph took to read.

This article is general information and does not replace advice from your doctor or pharmacist.

Frequently asked questions

Can I use coconut oil as a lubricant?

It can work. The BC Medical Journal guide says unrefined or virgin coconut oil is an option when latex protection is not needed. Oils weaken latex condoms, so if you rely on them, choose a water-based or silicone lubricant instead.

Can an at-home light device burn me?

It can. Health Canada has warned manufacturers that lasers, LEDs and other energy-based devices can cause thermal injury, and treats a device that raises skin above 45°C without sound scientific reason as unsafe. Use only Health Canada-licensed devices, and stop if anything feels hot.

I have had breast cancer. Can I use vaginal estrogen?

Talk to your oncologist first. The North American Menopause Society says there is not yet enough data to confirm its safety after breast cancer, and the 2025 American urology guideline says it may be considered through shared decision-making with your cancer team.

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