Vaginal dryness. It happens to most postmenopausal women, but few talk about it and even fewer get treated for it.
Vaginal dryness is a painful condition that occurs when the lining of the vagina does not produce enough lubrication. A healthy vagina has a thick discharge that keeps the tissues lubricated and healthy. When the body no longer makes adequate lubrication, the tissue becomes thin and dry, which may cause discomfort.
According to an article in the International Journal of Women's Health, approximately 50% to 60% of postmenopausal women suffer from this condition. Yet, only 25% receive treatment.
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Vaginal dryness can wreak havoc on a woman's quality of life. Painful sexual intimacy can be challenging to navigate in a relationship. Vaginal dryness can also cause discomfort when sitting or exercising, and it can lead to an increase in urinary tract infections (UTIs).
Vaginal Dryness Symptoms
According to the Mayo Clinic, some of the symptoms of vaginal dryness include:
- Painful sexual intercourse/penetration
- Itching in the perineum
- Burning when urinating
- Irritation of the perineum
- Bleeding post intercourse
- Vaginal discharge
- Recurrent urinary tract infections
Vaginal Dryness Causes
The Mayo Clinic states that a decrease in the body's production of estrogen is the primary cause of vaginal dryness. The body's drop in estrogen levels may be caused by:
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- Perimenopause
- Menopause
- Removal of ovaries (oophorectomy)
- Childbirth
- Breastfeeding
- Cancer treatment
- Douching
- Allergy and cold medications
- Vaginal atrophy
The North American Menopause Society notes that lower estrogen levels cause thinning and loss of elasticity of the vaginal tissue. These changes to the vaginal tissue can also change the pH of the tissue, and that can disrupt the balance of helpful and harmful bacteria.
Vaginal Dryness Treatments
Low estrogen levels usually cause vaginal dryness during sex. However, you should speak to your doctor about your symptoms. Your provider may order tests to check your hormone levels. They may also do a physical exam and lab work.
The Mayo Clinic recommends several different options for how to treat vaginal dryness.
Personal lubricants can help relieve the discomfort caused by sex. There are many types of lubricants available over-the-counter. When selecting the best lubricant for vaginal dryness, it is essential to remember that oil-based lubricants may damage condoms. Water-based lubricants are recommended because they have the fewest side effects. Personal lubricants work best if applied to the vulva and vagina area before penetration.
Vaginal moisturizers can be used along with personal lubricants. They are applied every 2-3 days. They help prevent the discomfort associated with vaginal dryness, even if you are not sexually active. According to an article in Frontiers in Reproductive Health, vaginal moisturizers "work by adherence to the vaginal mucosa, promoting hydration that stimulates lubrication." They also may contain ingredients that help maintain a healthy pH level.
Applying topical estrogen to the area can help heal the dry, damaged tissue. The estrogen usually comes in a tablet, cream or ring. It requires a prescription from your provider. According to Harvard Health, the amount of estrogen absorbed into the bloodstream is less than oral estrogen or the patch. It typically takes one to three months for symptoms to improve.
An oral medication, Ospemifne, treats vaginal dryness and does not contain hormones. This medication works by strengthening the superficial cell layer in the vagina, which can result in a decrease in dryness and pain, per the Mayo Clinic.
If personal lubricants and hormone therapy don't work, there is a new treatment for vaginal dryness. Laser therapy can rejuvenate the vaginal tissue safely. Dr. Susann Clifford, from Duke Women's Health Associates in Durham, N.C., says, "This non-hormonal, noninvasive intervention goes a long way to restore vaginal tissue to premenopausal levels. We're stimulating the body to heal itself."
Laser therapy stimulates the vaginal tissue to increase collagen and blood vessel formation. This treatment is not typically covered by insurance.
Vaginal dryness during sex can diminish the quality of life for any woman. Don't be shy; if your symptoms persist after trying lubricants and moisturizers, reach out to your provider.
