Discover ways to alleviate vaginal dryness. Meri Sehat provides insights and solutions for enhanced intimate well-being.

Vaginal Dryness

A. JABBAR DENTAL CLINIC KARACHI

Sadia Khan

Overview

Vaginal dryness is a reduction in the physiological lubrication of the vaginal tissues. 
&nbsp;

A normal vaginal lining is well-lubricated with fluid, which keeps it elastic and thick. Vaginal dryness means these tissues turn dry and thin due to a lack of natural lubrication.

The condition is most usually associated with the menopausal stage, when estrogen levels decline. However, it can occur at any age.<a href="#accordion">[1]</a>

Vaginal dryness is a common problem. According to research, more than 50% of women aged 51 and above experience mild or severe vaginal dryness related to menopausal changes. However, around 17% of them are affected before menopause as well.<a href="#accordion">[12]</a> 
&nbsp;

Sign and Symptoms

It is characterized by pain and discomfort in the vagina, particularly during sex. Other signs and symptoms include:<a href="#accordion">[13]</a>

<ul>
	<li>Vaginal itching or burning</li>
	<li>Bleeding after intercourse</li>
	<li>Recurrent yeast infections or urinary tract infections</li>
	<li>Soreness in the vulva</li>
	<li>Urinary incontinence 
	&nbsp;</li>
</ul>

Normal activities like sitting or walking, putting on underwear, and having sex become quite distressing. 
&nbsp;

Causes

These can be categorized into:<a href="#accordion">[14]</a> 
&nbsp;

<ul>
	<li>
	<h5>Hormonal Changes</h5>
	</li>
</ul>

Estrogen is important for maintaining vaginal tissue health and normal blood flow. The most common cause is a decrease in hormone levels, usually due to menopause, childbirth, breastfeeding, or some types of <a href="https://merisehat.pk/article/birth-control-the-female-prerogative-female-health">birth control.</a>

Cancer treatments and surgical interventions like a hysterectomy can reduce vaginal lubrication. 
&nbsp;

<ul>
	<li>
	<h5>Non-Hormonal Factors</h5>
	</li>
</ul>

These include <a href="merisehat.pk/disease/dehydration">dehydration</a>, inflammation, surgery, and poor mental health.

The vaginal tissue cannot function properly, for instance, if the individual has a poor water intake, is taking medications like antihistamines, or using certain lubricants, soaps, and perfumes that draw moisture out of the vaginal cells. Infections, too, affect these cells in the same way.

Additionally, if the person is not sufficiently aroused or is depressed or stressed out, then they may experience vaginal dryness during sex. 
&nbsp;

Diagnosis

Diagnosis often involves a detailed medical history and a pelvic examination. The doctor will ask about the symptoms the patient is experiencing, including any changes to the menstrual cycle (if applicable).

While there is no single test that can diagnose vaginal dryness, doctors usually proceed with a pelvic exam and, sometimes, a pap smear. Further, hormonal tests and vaginal pH tests may be ordered. This helps to rule out other conditions that present with similar symptoms. 
&nbsp;

Treatment

Treatment options for vaginal dryness include:

<ul>
	<li>Water-Based Lubricants And Vaginal Moisturizers, which are available over-the-counter, can be used during intercourse to alleviate discomfort and reduce the risk of UTIs. 
	For example, the use of hyaluronic acid vaginal gel is similar to topical estrogen therapy in improving symptoms of vaginal dryness<a href="#accordion">[11]</a>. 
	&nbsp;</li>
	<li>Estrogen Therapy In The Form Of Cream (e.g., Estrace and Premarin), pill (e.g., Imvexxy and Vagifem), or ring (e.g., Estring) helps deal with uncomfortable menopause symptoms like hot flashes. 
	&nbsp;</li>
	<li>Fractional Microablative CO2 Laser for women who cannot receive or did not show significant improvement from hormonal treatment.<a href="#accordion">[8]</a> 
	&nbsp;</li>
</ul>

Note: Topical estrogens are not recommended if the woman has breast cancer, vaginal bleeding, a history of endometrial cancer, or is pregnant or breastfeeding.Talk to your doctor about the pros and cons of medications, and always follow their instructions. 
&nbsp;

These include:

<ul>
	<li>Increased risk of developing UTIs</li>
	<li>Vaginal cracks, sores, and tears leading to bacterial and yeast infections</li>
	<li>Sexual problems, like low libido, painful intercourse, and inability to orgasm, that ultimately affect intimate relationships</li>
	<li>Fertility issues</li>
	<li>Psychological distress</li>
	<li>Reduced quality of life 
	&nbsp;</li>
</ul>

These include:

<ul>
	<li>Underlying medical conditions, such as thyroid disorders and Sjogren&rsquo;s syndrome</li>
	<li>Smoking</li>
	<li>At the perimenopause or postmenopausal stage</li>
	<li>Having no ovaries or uterus</li>
	<li>Certain medications, such as anti-allergies and anti-estrogen 
	&nbsp;</li>
</ul>

Improved natural lubrication can help prevent vaginal dryness.

<ul>
	<li>Stay hydrated.</li>
	<li>Avoid irritants, like scented soaps, douches, and oil-based lubricants (e.g., petroleum jelly and coconut oil), in and around the vagina.</li>
	<li>Take hormone replacement therapy, if applicable.</li>
	<li>Try sex therapy and engage in regular sexual activity.</li>
	<li>Strengthen weak vaginal muscles with pelvic floor exercises 
	&nbsp;</li>
</ul>

Key Points

<ul>
	<li>Vaginal dryness is a reduction of physiological lubrication of the vaginal tissues.</li>
	<li>Common symptoms include vaginal itching, pain during intercourse, and urinary incontinence.</li>
	<li>Treatment options include water-based lubricants, vaginal moisturizers, and estrogen therapy.</li>
	<li>Preventive measures include staying hydrated and avoiding irritants.</li>
</ul>

[1] Mac Bride, M. B., Rhodes, D. J., & Shuster, L. T. (2010). Vulvovaginal atrophy. Mayo Clinic Proceedings, 85(1), 87-94.

[2] 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.

[3] Kingsberg, S. A., Wysocki, S., Magnus, L., & Krychman, M. L. (2013). Vulvar and vaginal atrophy in postmenopausal women: findings from the REVIVE (REal Women's VIews of Treatment Options for Menopausal Vaginal ChangEs) survey. The Journal of Sexual Medicine, 10(7), 1790-1799.

[4] Simon, J. A., Kokot-Kierepa, M., Goldstein, J., & Nappi, R. E. (2013). Vaginal health in the United States: results from the Vaginal Health: Insights, Views & Attitudes survey. Menopause, 20(10), 1043-1048.

[5] Nappi, R. E., & Kokot-Kierepa, M. (2012). Vaginal Health: Insights, Views & Attitudes (VIVA) - results from an international survey. Climacteric, 15(1), 36-44.

[6] Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause, 20(9), 888-902; quiz 903-4.

[7] Sturdee, D. W., & Panay, N. (2010). Recommendations for the management of postmenopausal vaginal atrophy. Climacteric, 13(6), 509-522.

[8] Salvatore, S., Nappi, R. E., Parma, M., Chionna, R., Lagona, F., Zerbinati, N., ... & Leone, R. (2015). Sexual function after fractional microablative CO₂ laser in women with vulvovaginal atrophy. Climacteric, 18(2), 219-225.

[9] Faubion, S., Sood, R., & Kapoor, E. (2017). Genitourinary syndrome of menopause: management strategies for the clinician. Mayo Clinic Proceedings, 92(12), 1842-1849.

[10] Huang, A., Moore, E., Scholes, D., Lin, F., Vittinghoff, E., & Fihn, S. (2010). Vaginal symptoms in postmenopausal women. Menopause the Journal of the North American Menopause Society, 17(1), 121-126.

[11] Naumova, I. and Castelo-Branco, C. (2018). Current treatment options for postmenopausal vaginal atrophy. International Journal of Women S Health, Volume 10, 387-395.

[12] Goncharenko V, Bubnov R, Polivka J Jr, et al. Vaginal dryness: individualised patient profiles, risks and mitigating measures. EPMA J. 2019;10(1):73-79. Published 2019 Mar 2. doi:10.1007/s13167-019-00164-3