What Causes Vaginal Dryness?
Around 17% of women before menopause experience issues with vaginal dryness during or after sexual intercourse. Many women might experience dryness during sex because they are not properly aroused— either from stress, nervousness, or simply insufficient foreplay. Other reasons might be linked to hygiene products or harsh soaps, swimming pool chemicals and certain washing powders. Certain allergy medications and antidepressants that dry out mucous membranes may also affect vaginal tissues. As dryness is relatively common, sometimes it can be a simple problem to solve. Artificial lubricants that are similar to natural lubricants can be applied to the vulva and vagina in preparation for intercourse, and vaginal moisturisers can be used a few times a week; they do not have to be applied directly before intercourse takes place.
Vaginal dryness can also be a common problem for pre-menopausal women with low oestrogen levels, such as breastfeeding mothers, those who have had a hysterectomy, or those receiving chemotherapy. These hormonal changes can be dramatic and abrupt, particularly in the case of chemotherapy and hysterectomy where the ovaries have been removed. Decreased levels of oestrogen can cause menopausal effects to occur more quickly, or lead to a thinner and more fragile vaginal lining; both of which contribute to vaginal dryness.
After menopause, women find that their bodies begin to change. The ovaries stop producing reproductive hormones, and their levels steadily decrease. One of the earliest signs of reduced oestrogen is reduced lubrication during sexual activity. Without the production of oestrogen, the skin and tissues of the vulva or vagina can become thinner and less elastic, or dry. Approximately half of women post-menopause will experience vaginal dryness.
How Do You Know When Your Dryness Needs Treatment?
While vaginal dryness is common and can sometimes be rectified through simple lubricants or moisturisers, if the problem continues to persist you may require further treatments. Pain and discomfort during sex is to be somewhat expected, but if normal methods provide insufficient relief, seek advice from a medical professional. You may require some form of treatment if:
- You experience pain at times other than sex. In many cases, vaginal dryness can cause pain throughout the day, when you sit, stand, urinate, or exercise. If your dryness affects everyday life, whether you are sexually active or not, this can have a detrimental effect on your quality of life.
- Pap smears or cervical screenings become painful or difficult. Vaginal dryness might make your routine check-ups more than uncomfortable, and if they cause sufficient pain, you might hesitate to go to them, which is not advised.
- You notice a change in the appearance of the vagina. If your dryness is the product of menopause or hormonal changes, you might notice the lips of your vulva becoming much thinner, or less elastic.
- You experience a significant emotional impact. Vaginal dryness might make you feel different, and changes to the body can sometimes be difficult to accept. In addition, pain and discomfort might lead to a loss in self-confidence or sexual drive, which can impact your mental health.
- You notice changes to your vaginal discharge. Though this is usually the result of simple hormonal changes, if your discharge becomes discoloured, foul-smelling, or results in irritation and burning sensations, you should seek medical advice.
How Can Vaginal Dryness Be Treated?
The first step towards treatment is always recognising that your problems are common, that you are not alone, and that treatment itself is nothing to be embarrassed about. The next step is to talk to your healthcare professional, who can recommend a treatment to suit your lifestyle and individual symptoms. Make a list of what you want to discuss, and ask for clarification if there are things about the condition that you don’t understand. Your doctor might recommend:
- Local Oestrogen. Vaginal dryness can respond well to local oestrogen treatments that help balance the hormone levels in your body. These can also help greatly with discomfort and pain, as well as regulate bacteria. Local oestrogen treatments might take the form of small tablets inserted into the vagina with an applicator, gels and creams, or vaginal rings which are replaced every few months.
- Pessaries. A once-daily pessary, or a soluble medicine inserted into the vagina can help to regulate hormone levels through the release of Dehydroepiandrosterone (or DHEA).
- Ospemifene. A table treatment that has an oestrogen-like effect in the vagina, which is suitable for some women who are not candidates for vaginal oestrogen.
Your doctor might also examine you and recommend lifestyle changes, such as:
- Avoiding perfumed soaps
- Using creams to treat skin irritation
- Using lubricants or moisturisers which are particularly useful for women not suited to oestrogen replacement
- Taking more time before sexual intercourse and giving the Bartholin’s gland time to produce as much lubrication as it can; discuss foreplay and preparation with your partner.
Despite the commonness of the condition, vaginal dryness is something of a silent problem. Many women feel embarrassed to discuss the issue with their friends, partners and even health professionals. It is important to remember that women spend a third of their lives in a post-menopausal state, where vaginal dryness is very common, and you should make sure to maintain the quality of life you had before this state. Vaginal dryness does not need to be treated as something inevitable, or a consequence of growing older— something can always be done.