Vaginal dryness can be an embarrassing topic to broach, but can negatively affect the lives of many women.  Because it is not openly discussed, women may not know that it is a common problem especially for women during and after menopause.  Although less common, it can also happen to women who aren’t menopausal.  Are you suffering from vaginal dryness? Here are some common symptoms that might help you figure that out.                               

Symptoms

·         Burning on urination

·         Light bleeding after intercourse

·         Painful sexual intercourse

·         Slight vaginal discharge

·         Vaginal soreness, itching or burning

Some of the main causes of vaginal dryness include the following:          

• Hormonal changes: One of the most common causes of vaginal dryness is a decrease in estrogen levels during menopause, perimenopause, after childbirth, or during breastfeeding. Medical therapies for underlying conditions like cancer, such as chemotherapy or radiation, can also affect hormone balance and increase vaginal dryness.  
• Medications:  Any medication that contains an antihistamine can have a drying effect on the body overall, and that includes the vagina.  
• Insufficient arousal: For some women, the cause of their dryness is a decreased sex drive or issues within a sexual relationship.
• Irritants:  Chemicals in soaps, hygiene products, lubricants, dyes, and perfumes can cause allergic reactions within the vaginal area and contribute to uncharacteristic and uncomfortable dryness. 
• Anxiety: Emotional stress and anxiety can decrease sexual desire and kill any libido.  When a woman is having difficulty with arousal, vaginal lubrication can also be an issue, and dryness ensues.

We mentioned that hormonal changes are the most common cause of vaginal dryness, which is why it is most common in women at menopause. But any condition that in linked to low estrogen levels can result in vaginal dryness. Decreased levels of estrogen leads to thinning and inflammation of the labia typically called vaginal atrophy.

Causes of low estrogen include:

·         Radiation therapy

·         childbirth and breastfeeding

·         removal of the ovaries

·         treatment of uterine fibroids or endometriosis with anti-estrogen medications

·         Autoimmune disorders such as Sjogren’s

·         Douching

·         Lack of foreplay before sexual intercourse

Vaginal dryness is treated with estrogen replacement therapy, except for women with estrogen dependent tumors like endometrial cancer.  This hormonal therapy allows for the restoration of the normal vaginal pH (acidic), thickens the microflora and increases vaginal lubrication. Here are some of the therapies available:

Estrogen Therapy:

• Most common treatment is low dose topical estrogen therapy.  This method is preferred because it treats the condition without the disadvantage of systemic effects from higher doses of estrogen. 
• Vaginal estrogen ring is a soft, flexible ring that is placed into the vagina. This ring releases a steady stream of estrogen directly to the vaginal tissues.
• Vaginal estrogen tablet is a tablet that is inserted into your vagina once a day for the first two weeks of treatment which releases estrogen.  It is later inserted twice a week until you no longer needed.
• Vaginal estrogen cream involves an applicator and the insertion of the estrogen cream into the vagina. The frequency of use depends on the brand itself, and can vary from every day to once a week.