Vaginal Dryness: Causes and Moisturizing Treatments

Normally, the walls of the vagina stay lubricated with a thin layer of clear fluid. The hormone estrogen helps maintain that fluid and keeps the lining of your vagina healthy, thick, and elastic.

A drop in estrogen levels reduces the amount of moisture available. It can happen at any age from a number of different causes.

It may seem like a minor irritation. But the lack of vaginal moisture can have a huge impact on your sex life. Fortunately, several treatments are available to relieve vaginal dryness.

Causes

Vaginal dryness is common symptom of menopause -- and close to one out of every three women deals with it while going through "the change." It becomes even more common afterward. It also makes the vagina thinner and less elastic. This is called vaginal atrophy.

Estrogen levels can also drop because of:

• Childbirth and breastfeeding
• Radiation or chemotherapy treatment for cancer
• Surgical removal of the ovaries
• Anti-estrogen medications used to treat uterine fibroids or endometriosis

Other causes of vaginal dryness include:

• Sjögren's syndrome (an autoimmune disorder that attacks cells in the body that produce moisture)
• Allergy and cold medications
• Certain antidepressants
• Douching
• Not enough foreplay before sex

No matter what the cause, vaginal dryness can be extremely uncomfortable. It can lead to itching, burning, and painful intercourse.

Diagnosis

Any burning, itching, or discomfort in the area is worth a call to your doctor or gynecologist. They'll ask about your past health and find out how long you've had symptoms and what seems to make them worse or better.

Your doctor will do a pelvic exam, checking your vagina for any thinning or redness. The exam will help rule out other possible causes for your discomfort, including a vaginal or urinary tract infection. The doctor may also remove cells from your vaginal wall or cervix for a Pap test.

Medication

The most common treatment for vaginal dryness due to low estrogen levels is topical estrogen therapy. These replace some of the hormone your body is no longer making. That helps relieve vaginal symptoms, but it doesn't put as much estrogen in your bloodstream as the hormone therapy you take in pills.

Most women use one of three types of vaginal estrogen:

• Ring (Estring): You or your doctor inserts this soft, flexible ring into your vagina where it releases a steady stream of estrogen directly to the tissues. The ring is replaced every 3 months.
• Tablet (Vagifem): You use a disposable applicator to put a tablet into your vagina once a day for the first two weeks of treatment. Then you do it twice a week until you no longer need it.
• Cream (Estrace, Premarin): You use an applicator to get the cream into your vagina. You'll typically apply the cream daily for 1 to 2 weeks, then cut back to one to three times a week as directed by your doctor.

Any estrogen product can have side effects, such as vaginal bleeding and breast pain. Topical estrogen may not be recommended when you:

• Have breast cancer, especially if you're taking an aromatase inhibitor
• Have a history of endometrial cancer
• Have vaginal bleeding but don't know why
• Are pregnant or breastfeeding

There isn't much research on the long-term use of topical estrogen, but doctors believe it's safe.

Other Products

You can buy a vaginal moisturizer like glycerin-min oil-polycarbophil (Replens) at your local drugstore or supermarket.

A drug taken orally An oral drug taken once a day, ospemifeme (Osphena), makes vaginal tissue thicker and less fragile, resulting in less pain for women during sex. The FDA warns that Osphena can thicken the endometrium (the lining of the uterus) and raise the risk of stroke and blood clots.

Take your time before having sex to make sure that you're fully relaxed and aroused. Apply a water-based lubricant (Astroglide, K-Y) to help enjoy intercourse more.

Avoid using douches, bubble baths, scented soaps, and lotions around the sensitive vaginal area. These products can worsen dryness.

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