Vaginal dryness is a common issue affecting over half of women, yet it remains a largely taboo subject that many choose to keep silent about. Research indicates that over 50% of people with vaginal dryness don't report it to their healthcare provider, often due to embarrassment or the misconception that it is a normal and untreatable part of aging.
This silence leads to prolonged discomfort, decreased quality of life, and strained relationships as women endure the symptoms without seeking the help they need. Recognizing and addressing these misconceptions is the first step toward effective management and treatment, ensuring that affected women receive the appropriate support.
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What is Vaginal Dryness?
Vaginal lubrication is the natural moisture produced by the vagina and supportive glands. This lubrication is a physiological sign of sexual arousal and makes sexual activity comfortable and enjoyable.
Normal vaginal lubrication is achieved through a combination of healthy blood flow and secretions from nearby glands. During sexual arousal, increased blood flow causes fluid to pass through tiny spaces between the vaginal cells, creating a natural moisture known as transudate. Additionally, the Bartholin's glands located near the vaginal opening and the Skene's glands near the urethra produce mucus that further enhances lubrication.
Vaginal dryness refers to the lack of adequate moisture in the vaginal tissues, which can lead to vaginal discomfort, irritation, and pain, especially during sexual activity. Vaginal dryness is more common than you may realize: it affects 17% of premenopausal women and over half of women after menopause.
Causes of Vaginal Dryness
Estrogen is a sex hormone that, among other things, helps keep the vaginal tissues healthy and moisturized. Therefore, vaginal dryness is often related to declines in estrogen levels, which can occur during different stages of a person's life.
Hormonal Causes
Vaginal dryness is the primary symptom of genitourinary syndrome of menopause (GSM), formerly called atrophic vaginitis or vulvovaginal atrophy. GSM affects more than half of postmenopausal women and refers to the thinning and decreased elasticity of the vaginal walls caused by the decline in estrogen, leading to symptoms like:
- Vaginal irritation, itching, and burning
- Discomfort during sexual intercourse
- Urinary frequency and urgency
- Frequent urinary tract infections (UTIs)
Other factors besides menopause that can cause estrogen levels to drop include:
- Surgery to remove the ovaries
- Radiation treatment to the pelvis
- Chemotherapy
- Chronic stress
- Certain medications, such as hormonal birth control and anti-estrogens (used to treat endometriosis, fibroids, and cancer)
- Childbirth and breastfeeding
Non-Hormonal Causes
Reasons you might experience vaginal dryness unrelated to low estrogen levels include:
- Antidepressant medications
- Antihistamine medications used to treat allergies
- Smoking, which can reduce blood flow to the vaginal tissues
- Sjögren's syndrome, an autoimmune disease in which the immune system attacks the body's moisture-producing glands
- Diabetes
- Dehydration
- Douching or using scented soaps or perfumes around or in the vagina
- Not being sexually aroused
Symptoms and Diagnosis
While vaginal irritation and painful intercourse are two of the most common symptoms associated with vaginal dryness, it can also manifest in other ways, such as:
- Vulvar pain and dryness
- Discomfort while sitting, standing, and exercising
- Painful and frequent urination
- Recurrent UTIs or vaginal infections
- Low libido
- Bleeding after sexual intercourse
When to See a Doctor
If you experience persistent symptoms of vaginal dryness, it's important to consult a healthcare professional. Talk to your doctor if:
- Over-the-counter treatments do not alleviate symptoms
- You notice unusual vaginal discharge or bleeding
- You have severe pain or discomfort that affects daily activities
- Symptoms are affecting your sex life or relationship with your partner
- You have other symptoms that could indicate a systemic medical condition, such as dry eyes and mouth
Treatment Options for Vaginal Dryness
With a solid foundation of awareness, the next step for managing vaginal dryness involves exploring the various treatment options available. Whether you prefer medical interventions, lifestyle adjustments, or natural remedies, there are multiple pathways to alleviate vaginal discomfort.
Because individual results may vary, it's always advisable to consult a healthcare provider to determine the most appropriate treatment option for your specific needs.
Vaginal Moisturizers
Vaginal moisturizers can be purchased over the counter and are meant to be used regularly. They are inserted into the vagina or applied externally to the vulva to add moisture in and around the vagina.
A study with postmenopausal women found that using a non-hormonal vaginal moisturizer twice a week for three months significantly increased vaginal moisture and flexibility, improved the health of the vaginal tissues, and enhanced sexual function.
Lubricants
Lubricants are used during sexual activities to reduce friction, alleviate discomfort, and increase pleasure. There are water-, silicone-, and oil-based lubricants.
Oil-based lubricants, including lotions and vaseline, should not be used with latex or polyisoprene condoms, as the oil can break down the condom, making them less effective in preventing sexually transmitted infections (STIs) and unintended pregnancy.
Hormonal Therapies
Topical estrogen therapy is applied directly to the vaginal area. Unlike oral hormone replacement therapy, vaginal estrogen is absorbed into the body at much lower levels, resulting in a safer side effect profile.
A doctor can prescribe one of the following forms of topical estrogen therapy to treat vaginal dryness related to low estrogen levels:
- Vaginal Ring: A flexible ring inserted into the vagina that releases estrogen over time.
- Vaginal Cream: Applied directly into the vagina using an applicator. It is usually inserted vaginally every day for two weeks and then reduced to twice weekly.
- Vaginal Tablet: Inserted into the vagina using an applicator. It is typically inserted every day for two weeks and then reduced to twice weekly.
Hormonal therapies should be discussed and prescribed by a qualified healthcare provider to ensure suitability and safety.
Lifestyle Adjustments
These are things you can do on a regular basis to prevent and treat vaginal dryness:
- Steer clear of products that can irritate the vaginal area, such as scented soaps, douches, and feminine hygiene sprays.
- Wear 100% cotton underwear.
- Stay well hydrated by drinking plenty of water throughout the day.
- Quit smoking.
- Manage stress with practices like yoga, meditation, and deep breathing.
- Engage in regular sexual activity, alone or with a partner, to support healthy blood flow to the vaginal tissues. Adequate foreplay ensures full arousal before intercourse, enhancing natural lubrication.
Natural Remedies
Research suggests that these natural remedies may help women find relief from vaginal dryness:
- Pelvic Floor Muscle Training (PFMT): Also known as Kegel exercises, PFMT is a feasible and effective therapy for treating GSM. According to one study, positive outcomes associated with PFMT include improvements in vaginal moisture, tissue elasticity, and sexual function.
- Phytoestrogens: These are plant-based compounds that mimic the effects of estrogen in the body. Research suggests they may reduce vaginal dryness and hot flashes associated with menopause. You can increase your dietary intake of phytoestrogens by eating more soy products, nuts, seeds, and legumes.
- Vitamin E: In one study, researchers found that 100 IU vitamin E vaginal suppositories were as effective at managing the vaginal symptoms of GSM as estrogen cream after 12 weeks.
Emotional and Relational Impact
Studies have shown that vaginal discomfort leads to avoidance of intimacy, loss of libido, and painful sex, which in turn negatively affects the self-esteem and emotional well-being of women and their partners. This can result in decreased sexual activity and emotional distance between partners, contributing to relationship strain. In fact, as many as 30% of North American couples stop having sex due to vaginal discomfort.
To support their patients, doctors can help destigmatize vaginal dryness by educating them about the condition and offering effective management strategies, including those that specifically address the emotional toll:
- Encourage open communication between partners about symptoms and their impact. Healthcare providers can facilitate these discussions and provide comprehensive education about vaginal health and available treatment options.
- Cognitive behavioral therapy, sexual counseling, or marital counseling can be beneficial in addressing the psychological and relational aspects of sexual dysfunction, improving overall relationship satisfaction.
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Key Takeaways
- Vaginal dryness is a symptom that most women will experience at some point in their life.
- Health conditions, lifestyle factors, and taking certain medications are common reasons that the vagina can become dry, leading to uncomfortable vaginal and urinary symptoms.
- Despite the physical and emotional toll that vaginal dryness can cause, many women do not report this symptom to their healthcare providers, likely due to social misconceptions that have led this topic to become taboo.
- Various over-the-counter and prescription treatments are available to help women manage and alleviate the symptoms of vaginal dryness.
- If you're experiencing vaginal dryness, remember that you're not alone, and help is available. Seeking professional guidance is the first step to finding relief and practical solutions to regain vaginal and sexual comfort.
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