Vaginal dryness is a troublesome condition that many women experience at some point in their reproductive lives. In postmenopausal women, the prevalence of this condition is quite high, with 1 in 3 women experiencing it. This adversely affects their quality of life by causing irritation, itching, and pain during intercourse.
Normally, the vagina has a rich blood supply to keep the vaginal walls elastic and its surface lubricated. After menopause, the low levels of estrogen and the subsequent reduced blood flow to vaginal tissue lead to dryness and thinning of vaginal walls.
Causes
Estrogen is the hormone of youth. It is produced by healthy ovaries. Any condition or therapy that affects estrogen production by ovaries can potentially lead to vaginal dryness.
Causes of Vaginal Dryness
- Menopause
- Breastfeeding can lead to a delay in the resumption of ovarian activity
- Hormonal contraceptive methods inhibiting the cyclical ovarian activity
- Anti-estrogen therapies for fibroids and endometriosis
- Surgical removal of ovaries
- Pelvic irradiation or chemotherapy in cancer patients increases the risk of premature ovarian failure
- Hormonal or immunotherapy in cancer patients altering ovarian function
- Antihistamines used to treat sore throat and runny nose
- Antidepressants
- Sjogren’s syndrome, a disorder of the immune system causing dryness throughout the body
What Causes Vaginal Dryness During Sex?
Vaginal dryness causes discomfort during sexual intercourse. Aging, dehydration, stress, and lack of interest in sex can lead to vaginal dryness during sex. In the absence of lubrication, penetration, and friction during sex are painful. Relaxation techniques and foreplay can help overcome this condition. Using vaginal lubricants will help and so will communicating your symptoms with your partner.
Diagnosis
What Does Vaginal Dryness Feel Like?
With a dry vagina, you can encounter a range of issues including
- Dyspareunia or discomfort during and after sex
- Burning sensation in the vagina
- Itching
- Bleeding after intercourse
- Dysuria or pain while passing urine
- Increased frequency of urination
How is Vaginal Dryness Diagnosed?
Your doctor will usually diagnose this condition based on your history and the findings of your pelvic examination. The doctor might identify one or more risk factors from your clinical history.
Doctors then perform a pelvic examination, which shows loss of rugosities in the walls and a smooth and shiny vaginal mucosa, occasionally with reddish inflammatory patches. In some doubtful instances, your blood hormone levels may be checked to confirm the diagnosis of atrophy and dryness.
Treatment
Lubricants and Moisturizers for Vaginal Dryness
These are readily available in pharmacies and grocery stores without a medical prescription. They have a soothing effect on the vagina, alleviating the discomfort of dryness. Water-based products are most popular as they are easy to clean, don’t stain fabrics, and can be used with condoms.
Moisturizing agents like Luvena® and KY® Liquibeads are applied to the inside of the vagina every few days to keep it healthy. Products marketed as vaginal lubricants, such as Astroglide® and KY® Jelly, are recommended before sexual activity.
Medications for Vaginal Dryness
The medications used for vaginal dryness aim to replace the low estrogen levels in your body. A thorough evaluation by a doctor is warranted before starting these medications.
Estrogen Formulations
The vaginal estrogen formulations are available in creams, tablets, and rings for local application in perimenopausal symptomatic women. The estrogen delivered helps in rejuvenating the lining of the genital tract with some beneficial effects on urinary symptoms as well. Treatment usually takes 1 to 3 months for the results to become apparent.
Ospemifene
This is a drug that acts like estrogen by acting on the estrogen receptors of the vagina selectively, thereby reducing side effects associated with systemic estrogen treatment. It is used to treat painful sex due to vaginal atrophy.
Dehydroepiandrosterone
This is another drug that acts like estrogen on the mucosa. A vaginal suppository of DHEA is used to treat dryness and dyspareunia in menopausal women.
Vaginal Rejuvenation Treatments
This is an umbrella term used for procedures to enhance and restore the aesthetic appearance and functionality of vulva and vagina. Included in it are innovative techniques like O-Shot®. It greatly reduces dryness by reviving the tissue with the help of growth factors extracted from a woman’s blood.
Besides, minimally invasive treatments like labiaplasty improve the overall appearance and symmetry of the vulva. This leads to a more positive intimate body image which enhances the sexual pleasure and natural lubrication of the vagina. The Labiaplasty cost depends on if a unilateral or bilateral procedure is required.
Kegels Exercises
Engaging in kegels or pelvic floor muscle exercises is important for sexual health. They relieve painful spasms of muscles and improve their blood supply resulting in better arousal and lubrication of the vagina.
DID YOU KNOW?
Around 17% of women aged 18-50 experience problems with vaginal dryness during sex, even before the menopause takes place.
Natural Remedies for Vaginal Dryness
Foreplay in Intimacy
This is the most commonly advised way to enhance emotional connection and intimacy. It helps in arousal and natural lubrication of the vagina.
Natural Oils
Natural oils like coconut oil, sunflower oil, and sweet almond oil are beneficial for dry skin conditions. They are soothing to the skin. They may be used safely as external lubricants before sexual intercourse. Caution is needed when using condoms as they reduce their efficacy.
Hydration
Keeping yourself well hydrated may help with dryness of all mucosal surfaces, including the vagina.
Avoid Scented Products
Heavily scented bath soaps and lotions may irritate the sensitive lining of the vagina, causing dryness.
In a Nutshell
Vaginal dryness is a common condition in menopausal women due to estrogen deficiency. However, women may also face it at some point in their reproductive life span. It causes a range of troublesome symptoms, which adversely affect the quality of life. Many natural remedies and over-the-counter treatments are available to manage it. If the issue persists despite applying home remedies, better consult your healthcare provider for a tailored treatment plan.
About the Author
Dr. Jehan Ara is a highly qualified consultant obstetrician and gynecologist with a passion for writing and health education. She has more than 10 years of practical patient care experience. She is currently working as an Assistant Professor of Obstetrics and Gynaecology in a medical school and a clinical supervisor for postgraduate residents of obstetrics and gynecology in the affiliated teaching hospital. In addition to her clinical work, Dr. Jehan is also a passionate writer and educator. She regularly writes articles and blog posts on women’s health. She is committed to helping women understand their bodies and make informed decisions about their health.
Also Read: The Importance of Early Detection and Treatment of Vaginal Infections
