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Vaginal Dryness - Causes and Remedies

Although it is most common in women who are postmenopausal, vaginal dryness is also a common problem for women during menopause, especially among postpartum women, although inadequate vaginal lubrication can occur at any age, and is often characterized by dryness, inflammation, and thinning of the lining of the vagina and lower urinary tract due to a decline in estrogen or a hormonal imbalance.

Vaginal dryness affects approximately half of all women between the ages of 40 and 59, with over 80% of women suffering from vaginal dryness during perimenopause, menopause, and later years. Even women who are on or are weaning off of hormone replacement therapy (HRT) continue to experience bothersome symptoms of vaginal dryness and irritation.

When hormonal imbalance is the cause of vaginal dryness, there are simple steps you can take to improve your natural vaginal lubrication, which we will explore after looking at the root causes of vaginal dryness.

Causes of Vaginal Dryness

Vaginal dryness is a condition most frequently associated with menopause, but can occur at any time, in any woman, due a number of physiological, environmental, psychological and other factors including high levels of stress however, for most women, it is often a direct result of a hormonal imbalance, such as lower estrogen levels that occur naturally during menopause, or after removal of the ovaries, and during later years in life.

Normally, a thin layer of moisture always coats the walls of your vagina. When estrogen is present, it causes the walls of the vagina to thicken and produce a vaginal lubrication consisting of a clear/semi-clear fluid that seeps through the walls of the blood vessels encircling the vagina. When you're sexually aroused, more blood flows to your pelvic organs creating more lubricating vaginal fluid. Hormonal changes during your menstrual cycle, and as you age, affect the amount and consistency of this moisture.

Vaginal dryness occurs at certain times in a woman's life when the hormonal changes of menopause, childbirth, and breast-feeding disrupt this process, and the ovaries produce a decreased amount of estrogen, interrupting or altogether stopping the production of estrogen. This can be a permanent or temporary change. When estrogen decreases, the tissues of the vagina naturally thin, becoming less elastic, drier, and more fragile, and can occur from:

  • After surgical removal of the ovaries, chemotherapy, or radiation therapy of the pelvis for cancer
  • While using a variety of medications, including:
    • Provera® or DepoProvera®
    • Lupron® or Nafarelin®
    • Tamoxifen, Danazol, and Medroxyprogesterone
    • When these medications are stopped, estrogen production may resume normally.
  • Menopause, perimenopause, postmenopause
  • Hysterectomy and related surgeries
  • Menstrual cycle changes
  • Pregnancy, childbirth, and nursing, particularly if you breastfeed
  • Some hormonal contraceptives
  • Hormonal imbalance
  • Endometriosis drugs
  • Infertility drugs
  • Stress and fatigue

Cigarette smoking also affects the moisture in the vagina and can make vaginal dryness worse.

Symptoms of Vaginal Dryness

Some women have uncomfortable symptoms of vaginal dryness, such as pain during sex, burning vaginal discomfort or itching, or abnormal vaginal discharge, while others have no symptoms at all. Quite often however, symptoms include itching and stinging around the vaginal opening and in the lower third of the vagina. Because a lack of vaginal lubrication can make intercourse painful, vaginal dryness is a root cause of female sexual dysfunction. Women who suffer from vaginal dryness often dread intercourse and avoid sex which leads to a significant decrease in libido. Additional symptoms of vaginal dryness include:

  • Dryness
  • Itching
  • Burning
  • Irritation
  • A feeling of pressure
  • Pain or light bleeding with sex

Fortunately, there are several effective treatments for vaginal dryness.

Vaginal Dryness Treatments

Many women make lifestyle changes to deal with their symptoms, such as stopping sexual activity to avoid painful sexual intercourse caused by vaginal dryness, because they may not be aware that there are several effective treatments for vaginal dryness that will allow them to be free of discomfort and enjoy an active libido. There are three primary treatment options for women with vaginal dryness:

  1. Moisturizers and lubricants
  2. Vaginal estrogen
  3. Natural supplemental nutrients

All vaginal dryness treatments work temporarily. The vaginal dryness will return when the treatment is stopped, unless the ovaries make more estrogen.

Vaginal Moisturizers and Lubricants

Vaginal moisturizing agents and vaginal lubricants are a common treatment because they can be purchased without a prescription, they do not contain hormones, and they have few, if any, side effects.

Lubricants are designed to reduce friction and the discomfort from dryness during intercourse. The lubricant is either applied to the interior of the vagina or directly to the penis just before sex. Water-based lubricants, such as KY® Silk-E or Astroglide®, are the only kind of lubricants you should ever use. Petroleum-based or petroleum jelly lubricants such as Vaseline®, can damage latex condoms and diaphragms, interfere with the pH of your vagina and lead to infections (yeast, bacteria), and over time, can actually increase vaginal dryness. It's also important that hand and body lotions not be used to relieve vaginal dryness, since they, too, can cause infections and irritate the vaginal tissues.

Natural lubricants, such as vegetable oil or saliva, are easily available products that may be used as a lubricant with sex however, as with petroleum-based products, oil-based products are not recommended for use with condoms or diaphragms because the oil can damage the latex, potentially making it less effective in preventing pregnancy or sexually transmitted infections.

Vaginal Estrogen

Vaginal estrogen is available only by prescription, and is an effective treatment option for women with vaginal dryness however, as with all synthetic treatments there are risks, some of which are considerable.

Estrogens have been reported to increase the chance of womb cancer in postmenopausal women (those who have been through menopause), and especially in women who still have a uterus and are receiving estrogen-only hormone replacement therapy (HRT). Estrogens may also increase the risk of ovarian or breast cancer. When taken in combination with progesterone (another hormone) for HRT, estrogen infrequently causes heart disease, stroke, dementia, and breast cancer.

These risks appear to be dependent upon the length of time these drugs are used, and the dosage amounts. Therefore, these medicines should be used for the shortest possible length of time, at the lowest effective dose, so that you obtain the benefits while minimizing the risk of serious side effects from long-term treatment. Talk to your physician about the benefits and risks.


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