One ob-gyn shares how she helps her patients with vaginal dryness.
Vaginal dryness can cause irritation, burning, and pain with intercourse. It’s common after menopause, and it also can happen in the years leading up to menopause. Often, my patients notice symptoms when they haven’t been sexually active for a long time. Then they are intimate with a partner and find that sex is painful.
Here’s how I talk with my patients about vaginal dryness.
After and around the time of menopause, your body makes less estrogen. Estrogen is a hormone that helps maintain the vagina’s lubrication, elasticity, and thickness. Low levels of estrogen can cause thinning, drying, and inflammation of vaginal walls. This is called vaginal atrophy.
Low estrogen and vaginal dryness can happen at other times. Estrogen levels can fall after childbirth, with breastfeeding, during cancer treatment, or with anti-estrogen drugs.
Then there are non-hormonal factors. Cold and allergy medications and some antidepressants can dry out vaginal tissue. Sjögren syndrome, an autoimmune condition that can cause a dry mouth and eyes, also can cause vaginal dryness.
Dryness isn’t always just inside the vaginal canal. Less estrogen means less natural vaginal moisture. This can dry and irritate the vulva, the external female genital area. Women with vulvar dryness often notice irritation when they’re putting on their underwear.
Some women also have increased urinary frequency or repeated urinary tract infections (UTIs) along with vaginal dryness. When this group of symptoms happens during menopause, ob-gyns call it genitourinary syndrome of menopause.
For vaginal dryness by itself, I recommend trying over-the-counter moisturizers and lubricants.
See your ob-gyn if irritation and pain during sex don’t improve after 2 months of use, or if you have other symptoms.
I often talk with patients about hormonal treatments when vaginal dryness comes along with urinary symptoms or menopausal symptoms, such as hot flashes.
These treatments deliver less estrogen than typical hormone therapy and have fewer risks. Talk with your ob-gyn about the pros and cons of different hormonal options.
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