Some symptoms are linked. Vaginal dryness, for example, can contribute to pain during penetration, soreness, and itching.

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Gynecological symptoms aren’t regarded as the most common symptoms of Sjögren’s disease, a chronic autoimmune disease where inflammation affects moisture-producing glands. It often leads to a dry mouth and eyes.

But many people with the condition report gynecological symptoms that can have a big impact on quality of life, such as:

Some symptoms are linked. For example, vaginal dryness can contribute to pain during penetrative sex, as well as general soreness and itching.

And the timing of Sjögren’s can impact the likelihood of such symptoms.

Menopause, for instance, has been associated with many similar gynecological symptoms. It often occurs in the same decades of life as Sjögren’s disease.

Below, find a list of all the potential gynecological symptoms of Sjögren’s disease and how you can find relief.

Vaginal dryness tends to occur with menopause due to lower levels of estrogen.

But vaginal and vulvar dryness is significantly higher in people with Sjögren’s and presents at a younger age.

It may even appear before the typical mouth and eye dryness associated with the condition.

“The vagina itself has no secretory glands that can be affected directly by Sjögren’s syndrome,” explains Faina Gelman-Nisanov, MD, OB-GYN, at Maiden Lane Medical in New York.

“But the Skene gland and the Bartholin gland at the vaginal vestibule [opening] are secretory glands that provide lubrication to the vagina,” she explains. “Their involvement in vaginal symptoms is suspected but not clinically proven.”

While there’s not any specific treatment for vaginal dryness caused by Sjögren’s disease, generic treatments may help.

You can try:

Vaginal atrophy can be another symptom of Sjögren’s disease. It’s characterized by thinning tissues, loss of folds, and pale, dry skin in the area.

Again, this is common during menopause. But Sjögren’s seems to exacerbate the atrophy.

Some studies have found no evidence of vaginal atrophy in people with the condition.

Treatment may not be needed if you’re not experiencing any pain or discomfort.

But if the dryness it contributes to painful penetration and urinary conditions, a healthcare professional may recommend vaginal moisturizers, lubricants, or hormonal treatments.

The vaginal atrophy that can come with Sjögren’s may lead to the narrowing of the vaginal opening.

It’s unclear how many people experience this particular gynecological symptom.

But if things like penetrative sex and pelvic exams become difficult and uncomfortable, you may be experiencing it.

Pelvic floor exercises can help prevent stiffness in vaginal muscles. A vaginal dilator can also help open the vaginal canal over time.

Another sign of vaginal atrophy is thinning pubic hair. (This also naturally happens as you age.)

There are no statistics to show how many people with Sjögren’s disease experience changes to their pubic hair.

But frontal fibrosing alopecia (FFA), which causes hair loss around the front of the hairline and eyebrows as well as the pubic region,has been noted in people with the condition.

This particular symptom can’t be prevented, but treatment is available.

But if a healthcare professional believes your thinning hair is from FFA, they may prescribe anti-inflammatory medications or hair growth–promoting meds, like Rogaine or Propecia.

The vaginal dryness mentioned above can contribute to itching and burning sensations in the genital area.

Autoimmune conditions that affect the vulvar skin are also more common in people with Sjögren’s, though specific statistics are not available.

Lichen planus causes ulcers that may itch. Lichen sclerosus usually results in white, thick, and itchy patches of skin.

To reduce general vaginal itchiness, you can try wearing breathable cotton underwear and looser clothing.

When bathing or showering, use warm water to clean your genitals. Avoid any products containing dyes or fragrances and activities like douching, too.

If the itching or burning is occurring alongside skin changes, talk with a healthcare professional. They can inspect the area and may prescribe a topical steroid.

Vaginal dryness can mean less vaginal discharge, though it’s unclear how many people notice discharge changes.

This symptom is also common with menopause because reduced estrogen levels can have the same effect.

However, some people with Sjögren’s disease may notice more discharge, particularly if they’re experiencing things like spotting.

There’s no treatment needed for discharge changes. But targeting the underlying cause, such as dryness, may alleviate any discomfort.

According to a 2005 study with 215 participants, 58 of whom had Sjögren’s, menstrual bleeding that lasted for more than a week and bleeding between periods were significantly higher in participants with Sjögren’s.

Further 2020 research confirmed the condition appears to make vaginal bleeding more likely.

This more recent study linked increased bleeding with the potential damage vaginal dryness may cause, so treating the dryness through moisturizers, lubricants, or hormonal therapies may help.

Consult with a healthcare professional if you’re experiencing more bleeding than usual to find out the best options for you.

Vaginal dryness is again the likely culprit behind pain during vaginal penetration.

In fact, pain during penetrative sex may precede the more well-recognized symptoms of Sjögren’s disease, with major differences in pain levels found in people with and without the condition.

In one 1995 study, pain was present in 61% of participants with Sjögren’s compared with 39% of participants without the disease.

This can have a big impact on your quality of life, particularly your sex life.

As before, alleviating the dryness with an appropriate lubricant or hormonal treatment may reduce any discomfort.

People who have received a diagnosis of Sjögren’s or who are being evaluated for it “report pain with urination, increase in urinary frequency, and increased urge to urinate,” says Gelman-Nisanov.

But, she adds, “the rates at which these symptoms are due to Sjögren’s syndrome, an underlying bladder infection, or other bladder diseases, such as interstitial cystitis, is unclear.”

In one 2013 study, overactive bladder symptoms were found in 56% of participants with Sjögren’s.

Some tips for caring for your bladder and potentially preventing or reducing urinary symptoms include:

  • wiping away from your vagina and toward your anus after going to the toilet
  • urinating after penetrative sex or masturbation
  • remaining well hydrated so your urine remains light yellow
  • limiting your intake of acidic foods and beverages

According to Gelman-Nisanov, there’s limited data associating Sjögren’s disease with an increased risk of UTIs.

Some research has noted a higher risk of general vaginal infections due to the likes of dryness in the area.

Lubricating the vagina, taking vaginal probiotics, and staying hydrated can help prevent UTIs and other infections.

If an infection is already present, medication is usually needed to treat it. This may take the form of an antibiotic, antiviral, or antifungal medication.

More research is needed on the gynecological symptoms of Sjögren’s disease and how to prevent or treat them. But enough people report such symptoms to know they exist.

The best advice is to consult with a doctor or other healthcare professional about any concerning symptoms. They can give you an accurate diagnosis and develop a personalized treatment plan.

Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.