Vaginal dryness is an uncomfortable and often painful condition that occurs naturally during and after menopause. Menopause causes estrogen levels to decline, which causes the dryness. However, certain medications and immune disorders can also cause vaginal dryness. Your doctor can help you determine the right treatment for this condition, which may mean estrogen therapy or alternative methods, such as topical creams or dietary changes.
Vaginal dryness is very common in women going through menopause and for those who are postmenopausal. It can, however, be a problem at any age.
Estrogen is a hormone that is essential to keeping vaginal tissues healthy. This hormone helps to maintain the vagina’s normal lubrication, acidity levels, and elasticity. Therefore, when estrogen levels decline, the lining of the vagina becomes thinner and less elastic, and the vagina produces less lubrication. Estrogen levels drop during and after menopause, during childbirth and while breastfeeding, and from cigarette smoking. You may also experience a loss of estrogen if you have had your ovaries removed, been treated for cancer, or if you have certain immune disorders.
Some medications cause dryness throughout the body, including inside the vagina. Cold and allergy medicines can have this effect, as can some antidepressants. Chemotherapy medications, such as those used to fight breast cancer, can also cause dryness.
There are a couple more reasons why you may experience vaginal dryness, but they are less common. If you use a store-bought douche (vaginal cleanser), for instance, you are disrupting the natural balance of chemicals in your vagina. This can cause inflammation and dryness. A rare autoimmune disease called Sjögren’s syndrome, which causes dryness in the eyes and mouth, can also cause vaginal dryness.
It may seem embarrassing to bring up the topic of vaginal dryness with your doctor, but it is an important medical condition. The dryness can make you uncomfortable and be detrimental to your relationship because it can make sex very painful. As soon as dryness begins to interfere with your lifestyle, make an appointment with your doctor.
At your appointment, your doctor will likely ask you several questions about your symptoms, some of which may seem unrelated. Make sure to inform your doctor of all medications you are taking, both over-the-counter and prescription. Your doctor will also conduct a physical exam, which includes a pelvic exam.
During a pelvic exam, your doctor will press down on your abdomen while also inserting a gloved finger into your vagina. This is so he or she can detect any changes or abnormalities of the reproductive organs.
If your doctor is unable to pinpoint a cause for your dryness, or if you have other symptoms, you may need to undergo additional tests. You may need to have a pap smear, which is when your doctor collects cells from your cervix to test for infection and cancer. You may also have a sample from your vaginal tissues removed for testing.
Once your doctor knows what the underlying cause of your dryness is, you will be given treatment options. Although estrogen therapy is a common treatment, there are alternative options as well.
Hormone therapy may not be the right treatment for everyone. Replacing natural estrogen can help with dryness, but can also produce side effects. These include weight gain, fluid retention, nausea, headaches, breast tenderness, spotting of the skin, and increased risk of stroke, blood clots, dementia, and breast and ovarian cancers.
There are several alternatives to estrogen therapy, which work very well for many women and are often worth trying before using estrogen therapy:
- lubricant - Water-based lubricants help to add moisture to the lining of the vagina and can do so for hours at a time. This is a good alternative when dryness causes the most discomfort during sexual intercourse.
- vaginal moisturizers - Moisturizers made specifically for addressing vaginal dryness can be used to relieve symptoms for up to three days with just one application.
- sexual intercourse - Although dryness can make sex uncomfortable, having intercourse more regularly actually promotes natural lubrication.
- avoiding vaginal cleansers (douches) - There are products on the marketplace that are designed to cleanse the vagina, such as douches, soaps, and rinses. Avoid using these, as they will only make dryness worse.
- soy - Compounds in soybeans and soy products mimic the effects of estrogen. If you add soy to your diet, you may experience some relief from vaginal dryness.
- black cohosh - This is an herbal supplement that is considered by some to relieve menopausal symptoms. There is no evidence, however, that it really works.
- wild yam - This is another supplemental ingredient that promises to relieve dryness, but evidence from research is lacking.
Talk to your doctor before taking any kind of herbal medicine, as it may interfere with other medications, vitamins, or other herbs you are currently taking.