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.
Beyond menopause, certain medications and immune disorders can also cause vaginal dryness. Your healthcare provider 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 postmenopausal women as well. Here are some common causes:
Estrogen is a hormone that’s 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 can drop during and after menopause, during childbirth, and during periods of breastfeeding. You may also experience a loss of estrogen if you smoke cigarettes, have had your ovaries removed, have been treated for cancer, or 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 few additional, but less common, reasons why you may experience vaginal dryness.
If you use a store-bought vaginal cleanser or douche, for instance, you’re 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.
While it may seem embarrassing to bring up the topic of vaginal dryness with your healthcare provider, it’s an important medical condition and should be addressed sooner rather than later. The dryness can make you uncomfortable and can hinder your relationship because it can make sex very painful.
As soon as dryness begins to interfere with your lifestyle, make an appointment with your healthcare provider.
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 prescription and over-the-counter medications you’re taking. 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, lubricated finger into your vagina. This will help them 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 test, 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 the underlying cause of your dryness, you’ll 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. Some women aren’t good candidates for hormones because of a past history of disease, such as cancer.
Replacing natural estrogen can help with dryness, but can also trigger side effects. These include:
- weight gain
- fluid retention
- breast tenderness
- spotting of the skin
- increased risk of stroke, blood clots, and breast and ovarian cancers
There are several alternatives to estrogen therapy that work very well and are often worth trying before using estrogen therapy. They include the following:
- Water-based lubricants can help add moisture to the vaginal lining. Their effectiveness can last for hours at a time, making them a good alternative when dryness causes discomfort during sexual intercourse.
- Vaginal moisturizers made specifically for addressing dryness can be used to relieve symptoms for up to three days with just one application.
- 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 is an herbal supplement that’s considered by some to relieve menopausal symptoms. There are no significant clinical studies that show its effectiveness.
- Wild yam 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’re currently taking.
In addition to these alternatives, it’s also a good idea to avoid vaginal cleansers or douches. These products will only make dryness worse. And while dryness can make sex uncomfortable, having intercourse more regularly actually promotes natural lubrication.
Vaginal dryness is an uncomfortable condition, but it can be managed and treated.