What causes vaginal dryness and how can you treat it?

What causes vaginal dryness and how can you treat it?

Vaginal dryness affects 1 in 2 postmenopausal women, however, it can affect women at any age. About 17% of pre-menopausal women experience vaginal dryness.

Vaginal dryness could be one of the reasons why sex is painful or not as pleasurable as you’d like it to be. It doesn’t mean you can’t have a happy and healthy sex life if your vagina doesn’t produce too much natural lubrication on its own. Vaginal dryness is treatable. Let’s dig into some of its probable causes and solutions.

What is vaginal dryness?

During sexual arousal, your vagina gets lubricated with a thin layer of clear fluid that helps keep the lining of your vagina healthy, thick, and elastic. The hormone, estrogen is critical in the production of this fluid. A drop in estrogen levels reduces the amount of moisture available leading to vaginal dryness. The levels of estrogen in a woman’s body fluctuate due to age, medication, breastfeeding, and many other factors.

Symptoms and Key Factors

The most common symptoms of vaginal dryness are:

  • A burning sensation
  • Vaginal discomfort or itching
  • Abnormal vaginal discharge
  • Pain during sex or masturbation

1. Menopause and Vaginal Dryness

With age, women’s vaginal tissues become thinner and easily irritated, leading to a natural decline in the body’s estrogen levels. Vaginal dryness is most common in menopausal women with one in two women experiencing decreased lubrication. While other symptoms of menopause tend to decline with age, vaginal dryness doesn’t dissipate due to physical changes in the vagina.

2. Breast Feeding and Vaginal Dryness

Breastfeeding changes hormone levels in your body, and some women experience sexual changes as a result. In particular, oxytocin, estrogen, and prolactin play a role in both breastfeeding and arousal. Low estrogen levels resulting from the post-partum period and breastfeeding may result in vaginal dryness, tightness, or tenderness.

3. Hormonal Changes and Vaginal Dryness

Women on hormonal birth control pills which lower estrogen and testosterone, also experience a decrease in vaginal lubrication. In fact, any other medication that results in changes to reproductive hormone regulation can cause vaginal dryness. This would include women being treated for breast cancer.

Since your ovaries are responsible for producing reproductive hormones, estrogen, and progesterone, any conditions which affect ovary function or involve the use of hormonal pills for treatment such as PCOS, and endometriosis, can also increase the likelihood of vaginal dryness.

4. Hygiene and Vaginal Dryness

Excessive douching, or the use of strong vaginal products like soaps or perfume can also result in decreased lubrication.

5. Lifestyle and Vaginal Dryness

Cigarette smokers have been shown to have an increased risk of an earlier menopause transition as compared to non-smokers. These women would be more likely to experience vaginal dryness than their non-smoker counterparts.

A flower inside an underwear depicting a vagina
Choose cotton underwear, which promotes good airflow and allows the vagina to “breathe.”

How can you treat vaginal dryness?

Please consult your OBGYN before determining the right course of treatment for your unique situation.

A common treatment is topical estrogen therapy. This means medications that are applied directly to the vaginal area to relieve symptoms. Examples of topical estrogen therapies include:

  • Vaginal ring - This flexible ring is inserted into the vagina where it continually releases low amounts of estrogen into the tissues. The ring is replaced every 90 days.
  • Vaginal cream - An applicator is often used to apply the cream into the vagina. Research has shown that estrogen cream is an effective and well-tolerated treatment for vaginal dryness when compared with a placebo.
  • Vaginal tablet - This treatment also involves an applicator to place a tablet into the vagina.

Women with a history of breast cancer or who may be pregnant or breastfeeding should talk to their doctor about the safety of topical estrogen therapy.

There are non-hormonal treatment options too.

Lubricants or lubes are used at the time of intercourse to increase moisture and make sex less painful. Water-based lubricants are recommended over oil-based lubricants, as oil-based ones can lead to irritation and condom breakage.

Adequate foreplay and arousal before sex will help with vaginal dryness and make sex more enjoyable. Blood flow to the vaginal tissues increases when a woman is aroused, and this helps to stimulate moisture production.

There are several ways to combat vaginal dryness that involve simple lifestyle changes.

  • Avoid using strong vaginal hygiene products that may distort vaginal pH or wash away healthy bacteria.
  • Consume foods that contain phytoestrogens, a compound that mimics estrogen-like effects in the body. Plant-based foods such as soy, nuts, seeds, and tofu are rich in phytoestrogens.
  • Choose cotton underwear, which promotes good airflow and allows the vagina to “breathe.”

References

  1. Archer, D. F., Kimble, T. D., Lin, F., Battucci, S., Sniukiene, V., & Liu, J. H. (2018). A Randomized, Multicenter, Double-Blind, Study to Evaluate the Safety and Efficacy of Estradiol Vaginal Cream 0.003% in Postmenopausal Women with Vaginal Dryness as the Most Bothersome Symptom. Journal of women's health (2002), 27(3), 231–237. https://doi.org/10.1089/jwh.2017.6515
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