Vaginal Dryness

Pain, burning, and itching are just a few symptoms of vaginal dryness. Often an embarrassing topic to discuss, vaginal dryness will affect most people with a vagina at some point in their lifetime.

Low estrogen levels typically cause vaginal dryness, which leads to painful sex and pelvic discomfort. Although most common in postmenopausal people, vaginal dryness also affects nearly 20% of people between 17 and 50.

This article will discuss the symptoms of vaginal dryness, its causes, and treatment options.

Symptoms of Vaginal Dryness

Before menopause, the vagina can produce up to one teaspoon of fluid daily, causing it to be naturally moist. The fluid helps prevent vaginal and urinary tract infections and keeps the vagina lubricated. However, the vagina can become inflamed and irritated when less fluid is produced. Here are common signs of vaginal dryness:

• Itching, burning
• Pain with intercourse
• A small amount of bleeding after intercourse
• Pelvic discomfort
• Decreased libido
• Frequent urinary tract infections UTIs)

Vaginal dryness can happen at any age, be sure to see your healthcare provider if you are experiencing symptoms.

Causes of Vaginal Dryness

Although premenopausal people can have hormonal fluctuations causing vaginal dryness, other reasons for the symptoms include:

• Not being sexually aroused before intercourse
• Douching
• Using feminine sprays or powders
• Dehydration
• Vasoconstriction (poor blood flow to the vagina)
• Medications
• Childbirth
• Breastfeeding
• Chemotherapy, radiation
• Hysterectomy (removal of the uterus)
• Oophorectomy (removal of one or both ovaries)

Most people with a vagina over 50 commonly experience vaginal dryness. This is because decreasing estrogen levels causes the vaginal tissue to shrink and become thin, resulting in dryness, inflammation, and irritation. Other medical conditions, such as Sjogren's syndrome (autoimmune disease), can cause vaginal dryness.

Medications That Cause Vaginal Dryness

Medications with a drying effect, such as decongestants and allergy medications, can also lead to vaginal dryness. Estrogen-lowering drugs used for breast cancer reduce the amount of fluid the vagina produces. Other drugs that have been linked to vaginal dryness include:

• Birth control medications
• Antidepressants
• Certain heart medications
• Sedatives and antipsychotic drugs

Unfortunately, many people stop taking prescribed medications due to unwanted sexual side effects. Discuss any symptoms of vaginal dryness with your healthcare provider before eliminating any medications.

How to Treat Vaginal Dryness

Increasing estrogen can improve the symptoms of vaginal dryness. Over-the-counter (OTC) remedies, prescription medications, and energy-based devices may help restore the ability to produce vaginal fluid.

Over-the-Counter Remedies

Vaginal lubricants can help reduce pain during sex. There are water-based, oil-based, and silicone lubricants available. Oil-based lubricants can damage condoms and diaphragms, making them less effective against pregnancy; this includes natural products such as olive oil, coconut oil, and avocado oil.

Vaginal moisturizers are also helpful in decreasing dryness. Applying the gel or suppository into the vagina up to three times weekly helps the vaginal tissue retain moisture.

Prescription Medications

Vaginal and oral medications that contain estrogen (prasterone) or mimic estrogen, such as Osphena (ospemifene), require a prescription. Vaginal estrogen is available in creams, pills, suppositories, or a flexible plastic ring.

Vaginal Rejuvenation

Vaginal rejuvenation is a term that describes several types of vaginal treatments, including laser therapy. These treatments may improve the lining of the vagina by rebuilding collagen, resulting in less vaginal dryness. More research is needed to determine the effectiveness of such therapies.

Complications and Risk Factors of Vaginal Dryness

Left untreated vaginal dryness can cause vaginal sores, cracks, or tears, leading to yeast and bacterial infections. Increased risk of urinary tract infection is also linked to untreated vaginal dryness. Although vaginal atrophy does not develop from vaginal dryness, it is a chronic and progressive condition that can worsen the symptoms of vaginal dryness.

Risk factors for vaginal dryness include being postmenopausal, having no uterus or ovaries, being on medications that cause vaginal dryness, and smoking.

How to Diagnose Vaginal Dryness

Although there isn't a specific test to diagnose vaginal dryness, here is what you can expect from your healthcare provider:

• Medical history, including the length, time, and severity of your current symptoms
• Menstruation history
• Pelvic exam to inspect the vaginal tissue and possibly swab for an infection
• Bloodwork to check hormone levels

When to See a Healthcare Provider

If you are experiencing recurrent UTIs, yeast infections, and have symptoms of vaginal dryness that do not improve with home remedies, you should see your healthcare provider.

Summary

The symptoms of vaginal dryness include itching, burning, pain during sex, and pelvic discomfort. Although low estrogen levels are the leading cause of vaginal dryness, other factors such as medications, hygiene products, and medical conditions can also be a source. Fortunately, treatment is available to improve the symptoms of vaginal dryness. Left untreated, however, infection and chronic pain can result.

A Word From Verywell

Talking to your healthcare provider about vaginal dryness may feel embarrassing and uncomfortable. Many people suffer in silence because they are unsure how to approach the subject. Making a list of questions before your appointment can help break the ice. Write down what you're being told so you can review the information in the comfort of your home. Then, if you don't understand something, ask for clarification.