Vaginal Dryness
Vaginal Atrophy: Vagina Tissues Thin And Dry Out

Menopause Guide


Vaginal Dryness


What Is Vaginal Dryness?
What Causes It?
What Are The Symptoms?
How Is It Diagnosed?
How Is It Treated?
Are There Any Natural Treatments?

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What Is Vaginal Dryness?

Vaginal dryness is a common problem for most women after menopause, although lack of vaginal lubrication can occur at any age. It is usually noticed during intercourse when lack of lubrication makes love making painful. In younger women it may be a temporary condition caused by lack of foreplay, or an allergic reaction to a product they are using. Prolonged dryness is usually a sign of an underlying condition called vaginal atrophy (also called atrophic vaginitis and senile vaginitis) - a thinning and inflammation of the tissues lining the vulva and vagina. While this happens gradually to all women, it often worsens after menopause when estrogen levels are consistently low. Women also tend to be prone to vaginal dryness at other times in their life when estrogen levels are disrupted such as after childbirth or while breastfeeding.

What Causes It?

Estrogen helps to keep the vagina healthy by maintaining lubrication, skin elasticity and acidity balance. These conditions facilitate sexual intercourse, as well as create a natural defense against vaginal and urinary tract infections. When estrogen levels fall, this defense system falls with it. The vaginal and vulva tissue becomes thinner and fragile (prone to tearing); and production of lubrication falls making intercourse uncomfortable. Estrogen levels can fall for a number of reasons:

• Menopause
• Smoking
• After surgical removal of the ovaries.
• If the ovaries are damaged by cancer treatments, including radiation therapy, hormone therapy and chemotherapy.

Other causes include:

• Not enough foreplay before intercourse, or not feeling aroused by your partner.
• Stress (read about the dangers of stress and take our stress test).
• Reaction to washing powders.
• Reaction to swimming pools or hot tub chemicals.
• Autoimmune disorders like Sjogren's syndrome can cause dry eyes and mouth as well as vaginal dryness.

What Are The Symptoms?

Vaginal dryness can lead to the following symptoms:

Painful intercourse, sometimes with light spotting or bleeding.
• Itching and burning around the vulva.
• Soreness.
• Need to urinate frequently and urgently.

How Is It Diagnosed?

Your doctor will be able to diagnose vaginal atrophy with a pelvic examination. He may also perform a Pap smear of vaginal cells (as opposed to cervical cells) to examine the cell structure more closely. You may need to provide a urine sample if you have urinary symptoms. A biopsy (small sample of vaginal tissue) may be taken to rule out other underlying causes such as vaginal cancer or lichen sclerosus. Any bleeding in postmenopausal women needs to be closely investigated. An endometrial biopsy will probably be ordered to rule out endometrial cancer (cancer of the womb), as doctors can not always tell where the blood comes from.

How Is It Treated?

If your symptoms are not hormone related - resolving the underlying cause will rectify the problem. This may mean for example, practicing stress reduction techniques, avoiding possible chemical stimulants like swimming pools and hot tubs and so on. Painful intercourse can be relieved by using lubricants like K-Y jelly, Astroglide or Vagisil Intimate.

If vaginal atrophy is diagnosed, estrogen therapy is recommended. Topical estrogen (applied directly to the skin with a cream or inserted as a suppository) is more effect than oral estrogen (pills). Recommended treatments include:

Vaginal estrogen cream (Estrace and Premarin): These are creams that are inserted directly into the vagina with an applicator daily for 2 weeks and then once or twice a week thereafter.
Vaginal estrogen ring (Estring): This is a small ring which is inserted into the upper part of the vagina like a diaphragm. It emits small doses of estradiol (a type of estrogen) daily for 3 months and then needs to be replaced.
Vaginal estrogen tablet (Vagifem): You use an applicator to deposit an estrogen tablet into your vagina. You may need to insert one tablet daily for the first 2 weeks and twice a week thereafter.

If your symptoms are associated with other menopause symptoms like hot flashes, night sweats and menopause depression, your doctor may recommend higher doses of estrogen in the form of patches, pills or gels.

Are There Any Natural Treatments?

Home Remedies
1. Some women report benefits with yogurt. Insert yogurt (on its own or mixed as 1 tablespoon of yogurt with 1 tablespoon of vegetable oil) once a week into the vagina with an applicator. It may help prevent the vagina drying out and restore acid balance.
2. Replens is a vaginal moisturizer that contains an ingredient called pilocarpine - it sticks to vaginal tissue and artificially thickens it. Replens should only be used every other day. Generally however these types of products do not work for moderate or severe cases of vaginal dryness.
3. Regular sexual intercourse/stimulation: Even though you may not feel like it, the more often you are sexually simulated, the more secretions your vagina emits.
4. Practice kegel exercises regularly to strengthen the vaginal muscles.

  Related Articles on Vaginal Dryness

Reproductive system disorders: Symptoms of common gyno complaints.
Postpartum sex: Common problems after childbirth.

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