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Vaginal Dryness: Causes, Symptoms, and Effective Treatment

Vaginal dryness is quite a common symptom, although it's more widely spread among women in menopause. Learn more about this condition with Flo: all the vaginal dryness causes and its effective treatment.
Moisturizer for vaginal dryness

What is vaginal dryness?

Vaginal dryness is a common problem in women but a treatable one that can happen at any age, but is a particular issue for women who are going through or have experienced the menopause.

It happens primarily because of the decrease in estrogen levels. Fortunately, several treatments are available to relieve vaginal dryness.

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Vaginal dryness symptoms

  • itching, burning or soreness around the vagina (vulva)
  • burning sensation during urination
  • increased urination frequency
  • pain during sexual intercourse, accompanied by light bleeding
  • low libido
  • thinner vaginal lips (labia)
  • urinary tract infections that do not go away or that reoccur

Causes of vaginal dryness

Causes of vaginal dryness include:

Insufficient arousal

In some cases, the cause of vaginal dryness is insufficient arousal with a partner. A woman’s body is designed to release a slippery natural lubricant when she is sexually turned on. Women who are too distracted or are transitioning to menopause or have attained menopause produce low estrogen hormone that keeps the vagina well-lubricated and moist. As a result, their vagina becomes dry and itchy. 

Medications

Several medications also cause vaginal dryness:

  • antihistamines
  • certain antidepressants
  • some birth control methods, like birth control pills and contraceptive injections

Sjogren's syndrome

Sjogren's syndrome is an autoimmune health disorder in which the body’s immune system targets its own moisture-secreting glands. Sjogren's syndrome can also impact the vaginal lubrication in women. It can lead to dryness in the vagina.

Stress and anxiety

Anxiety and mental stress can result in the production of elevated amounts of the hormone epinephrine. This hormone interferes with the body’s sexual response cycle and hence obstructs vaginal lubrication. 

Douching and other irritants

The chemicals in soaps, dyes, and perfumes cause irritation and allergies. There can be irritants on things like underwear or towels. Another reason for vaginal dryness is douching. 

Hormonal changes

A decrease in estrogen hormone level that takes place during menopause is a significant cause of vaginal dryness. The reduction in estrogen may also happen while women are experiencing perimenopause and during breastfeeding or after childbirth. 

Some other causes of vaginal dryness include:

  • treatment for cancer (chemotherapy and radiation therapy)
  • surgical menopause — surgical removal of ovaries
  • birth control pills
Applying cream for vaginal dryness

Vaginal dryness in menopause

Vaginal dryness is one of the symptoms of menopause. The main cause is the drop in estrogen levels that comes with the latter. Vaginal atrophy and vaginal dryness can result in burning, pain, itching, and discomfort during sexual intercourse and increase the risk of vaginal infections.

Vaginal dryness is a hallmark sign of the genitourinary syndrome of menopause. In this manifestation, the vaginal tissues become thinner and easily irritated. Alleviated estrogen levels also cause thinning of the urinary tract lining that causes frequent urination and UTIs. All these symptoms are known as GSM or genitourinary syndrome of menopause. With genitourinary syndrome of menopause, women also experience bleeding after sexual intercourse or discomfort, vaginal itching, and burning. These symptoms influence how a woman enjoys her sex life.

Vaginal dryness treatment

Several vaginal dryness remedies and treatment options are available:

Lubricants

Lubricants are a natural place to start. They help in alleviating pain during sexual intercourse in women with mild to moderate vaginal dryness. Vaginal lubricants come in gel or liquid form and can be applied to the vulva and the vagina for minimizing the friction associated with dry and thin genital tissue. Lubricants eliminate vaginal dryness and offer temporary relief from vaginal dryness especially during sex. They are not absorbed into the skin. Vaginal lubricants come in 3 forms; water-based lubricants, silicone-based lubricants, or oil-based products (these include petroleum jelly). Oil-based products should be avoided as the oil breaks down the latex and makes the condoms easier to break. Lubricants such as petroleum jelly can destruct the latex condoms and diaphragms used for birth control.

Vaginal moisturizer

Vaginal moisturizer is a type of cream applied inside the vagina to keep it moist. Applying a water-based vaginal moisturizer every few days is very effective. Water-based vaginal moisturizer is the best as its effect lasts longer than a lubricant.

Vaginal estrogen

Examples of topical estrogen therapies include:

  • Estradiol vaginal ring. It is a flexible ring with a core comprising a drug reservoir of estradiol. It is inserted into the vagina into the upper 1/3rd of the vaginal vault where it continually releases estrogen into the vaginal tissues. The ring should be replaced every 3 months. This ring serves as an estrogen reservoir for the treatment of urogenital issues caused by postmenopausal atrophy of the vulva/vagina (like burning, dyspareunia, dryness, and pruritus). 
  • Vaginal cream. The cream is applied into and around the vagina to get relief from vaginal dryness, itching, and burning. 
  • Vaginal tablet. The tablet is inserted in the vagina with a convenient, applicator while standing up or lying down. The tablet treats the underlying cause of menopause-related vaginal dryness by helping to replenish the estrogen levels in the vagina.

Hormone replacement therapy (HRT)

HRT is also known as menopausal hormone therapy or postmenopausal hormone therapy. When women transition to menopause, the estrogen levels drop causing the vaginal dryness.  Estrogen hormone keeps the vaginal tissues well lubricated and healthy. In search of relief, hormone replacement therapy is also considered as one of the solutions.  

Cream to cure vaginal dryness

Natural remedies for vaginal dryness

Regular sex

Regular sexual intercourse can help with vaginal dryness. Blood flow to the vaginal tissues elevates when a woman is sexually aroused, and this assists in stimulating moisture production. Sufficient foreplay and arousal prior to sex helps with vaginal dryness and makes vulva moist and well lubricated and thus sex is more enjoyable.

Hygiene tips to prevent vaginal dryness

  • Never use scented feminine hygiene products, as they might upset the harmony of the vaginal flora.
  • Refrain from using items that cause irritation, such as douches. Do not use condoms that have nonoxynol-9, or N-9. These cause vaginal dryness.
  • Use a soap-free cleanser which contains a lipid-enriched formula that maintains the hydrolipid film and natural lubrication of the vaginal areas.
  • Always use vaginal lubricants and moisturizers which are free from parabens and skin irritants.
  • Avoid over washing the vaginal and vulvar areas as that can lead to imbalances in vaginal and vulvar flora, which eventually results in infections (like mycosis). 
  • Refrain from products that contain antiseptic ingredients, as such products can wreck the lactobacilli (friendly bacteria in the vaginal flora) and cause damage to the mucosa and in the vulva region near the vaginal entrance. Use gentle products.

Foods that contain phytoestrogens

Phytoestrogens are compounds that act similarly to estrogen in the body. They are found in plant-based foods, including soy, nuts, seeds, and tofu.
Research suggests that phytoestrogens are associated with a modest improvement in vaginal dryness and hot flashes.

Underwear

Avoid wearing underwear made from synthetic fabrics as these trigger chafing and redness and also cause infections. Synthetic materials like nylon, spandex and polyester trap heat and moisture. Excess heat and moisture are the conditions, bacteria and yeast thrive in and cause infections.  Cotton underwear is the best for your vaginal health as cotton is breathable and wicks away moisture.

Bachmann, G., & Santen, R. J. (2016). Treatment of genitourinary syndrome of menopause (vulvovaginal atrophy). UpToDate online database. Available at www.uptodate.com (with subscription). Retrieved online on November 14, 2018.
Domoney, C. (2014). Treatment of vaginal atrophy. Women’s Health, 10(2), 191-200.
Edwards, D., & Panay, N. (2016). Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition? Climacteric, 19(2), 151-161.
Gandhi, J., Chen, A., Dagur, G., Suh, Y., Smith, N., Cali, B., & Khan, S. A. (2016). Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. American journal of obstetrics and gynecology, 215(6), 704-711.
Huang, A. J., Moore, E. E., Boyko, E. J., Scholes, D., Lin, F., Vittinghoff, E., & Fihn, S. D. (2010). Vaginal symptoms in postmenopausal women: self-reported severity, natural history, and risk factors. Menopause (New York, NY), 17(1), 121.
Mac Bride, M. B., Rhodes, D. J., & Shuster, L. T. (2010, January). Vulvovaginal atrophy. In Mayo Clinic Proceedings (Vol. 85, No. 1, pp. 87-94). Elsevier.
Santoro, N., Epperson, C. N., & Mathews, S. B. (2015). Menopausal symptoms and their management. Endocrinology and Metabolism Clinics, 44(3), 497-515.
Waetjen, L. E., Crawford, S. L., Chang, P. Y., Reed, B. D., Hess, R., Avis, N. E., ... & Study of Women's Health Across the Nation (SWAN. (2018). Factors associated with developing vaginal dryness symptoms in women transitioning through menopause: a longitudinal study. Menopause, 25(10), 1094-1104.
Weber, A. M., Walters, M. D., Schover, L. R., & Mitchinson, A. (1995). Vaginal anatomy and sexual function. Obstetrics & Gynecology, 86(6), 946-949.

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