Are you having pain during sex?
Is your private area constantly feeling sore or itchy?
If your answer to these questions is “Yes,” you may be suffering from vaginal dryness.
Normally, your body keeps your vaginal area moist by producing various fluids/secretions that serve as lubricants.
Vaginal dryness occurs when there is inadequate production of these lubricants.
The condition is common and can affect women of any age. But, it is more common in older women who have reached or are past menopause.
There are many reasons why you may be dry down there. Thankfully, there are also several reliable and safe treatment options for this. Read on to learn more.
Signs and symptoms of vaginal dryness
Vaginal dryness may present as:
- chafing and irritation of the vulva and vagina
- discomfort or pain during penetrative sex
- feeling sore, itchy, or having a burning sensation around or inside the vagina
- bleeding after sexual intercourse because of vaginal wall tears
You may experience other problems along with vaginal dryness, such as recurrent urinary tract infections (UTIs) or frequent urge to urinate.
Why am I dry down there all of a sudden?
There are several reasons why your vagina may be dry:
1) Menopause
Menopause is one of the most common causes of vaginal dryness. It occurs when your ovaries stop releasing eggs, and your menstrual cycle comes to an end.
There is a drop in the levels of estrogen which can cause your vaginal walls to become thinner and reduce the production of lubricating secretions.
In addition to vaginal dryness, other symptoms of menopause include:
- mood swings
- hot flashes
- difficulty sleeping
- headaches
- weight gain
- bloating
2) Childbirth and breastfeeding
After delivery of the baby and placenta, estrogen levels drop while the levels of prolactin (the hormone that is responsible for the production of milk) increase.
Due to the drop in estrogen, you may experience some dryness down there. Different people experience varying degrees of dryness that could lead to discomfort and even pain during this period.
Your estrogen levels should slowly return to normal once you stop breastfeeding, and the vaginal dryness should be reversed.
3) Certain diseases
Some medical conditions like diabetes and Sjogren’s syndrome can cause vaginal dryness because of the way they affect the body.
People with diabetes can have high blood sugar levels, which can damage the blood vessels, including those that are down there. This could lead to less lubrication.
Sjogren’s syndrome is a chronic, autoimmune condition that affects the moisture-producing glands in the body, like the eyes, mouth, skin, and vagina.
4) Vaginal douching
This refers to the process of using a liquid solution to cleanse the vagina. Women douche for different reasons like cleaning the vagina, preventing or treating an infection, etc.
However, this practice is not recommended as it can have harmful effects.
When you douche, you may remove the mucus secreted on the vaginal wall and cause it to get dry.
Douching also affects the natural PH of the vagina, which can favor the growth of certain infections.
5) Removal of the ovaries
The ovaries produce estrogen and progesterone. If they are both removed (during a surgical procedure called oophorectomy), the menstrual cycle stops immediately, and menopause begins.
One or both of your ovaries may be surgically removed for different reasons, e.g., ovarian cysts, endometriosis, infection of the ovary and the surrounding tissues, and ovarian torsion.
It may also be done as a preventive measure against breast and ovarian cancer.
6) Inadequate sexual stimulation
Sexual arousal involves mental, emotional, and physical factors. If you are not aroused, your brain will not send signals to the tissues responsible for producing vaginal lubrication. This can cause a dry vagina and painful sex (dyspareunia).
7) Medications that cause vaginal dryness
Some drugs can affect the processes that contribute to vaginal lubrication. These include:
- Birth control pills: Hormonal contraceptives can cause vaginal dryness because they can cause alterations in your hormone balance, leading to low estrogen levels.
- Antihistamines and decongestants: These are medicines used to treat colds and allergies. They work by narrowing your blood vessels to reduce moisture and mucus in your body. This effect may affect the vagina and cause dryness.
- Antiestrogen drugs: Estrogen modulators, such as tamoxifen and raloxifene, block estrogen receptors leading to low levels of estrogen, which can consequently cause decreased vaginal moisture. These anti-estrogen medications are used to treat some gynecologic conditions such as endometriosis and uterine fibroids.
- Chemotherapy agents: Chemotherapy drugs are used to treat cancer. They can affect estrogen release, reducing the amount in your circulation.
- Antidepressants: These drugs, specifically a class called selective serotonin reuptake inhibitors (SSRIs), can have adverse effects on sexual function e.g. vaginal dryness.
Always inform your healthcare provider if you notice any side effects from the medicines you are taking.
Do not stop taking any prescribed medication without the recommendation of your healthcare provider.
Medical treatments to increase vaginal lubrication
There are several methods you can use to treat vaginal dryness and improve lubrication. These include lubricants, medications, and some natural remedies.
Vaginal dryness is mostly caused by conditions that lead to estrogen levels decreasing. Several medications are available that aim to replace the deficit of estrogen or mimic the action of estrogen.
Other medications are designed to address the dryness without any hormonal action. Some of these medications are available over the counter, while others are prescription-only.
Vaginal lubricants
These are substances that help to decrease friction caused by dryness during penetration. You apply the lubricant directly inside the vagina and on your partner’s penis, fingers, or sex toys before sex.
Water-based or silicone lubricants are preferred when using condoms or diaphragms. It is best to buy lubricants that have been specifically designed for the vagina as they are more effective and less likely to cause irritation.
Vaginal moisturizers
Moisturizers are another option that can help ease vaginal dryness without altering hormone levels.
They are available as gels or suppositories that can be applied to the vagina to help it produce and retain moisture.
Unlike lubricants which are meant to be used temporarily during sex to ease penetration, the effects of vaginal moisturizers last longer, and they are meant for more regular use. They can be applied up to three times a week.
Make sure you look at the label when buying a moisturizer to be sure it is not a lubricant. Hyaluronic acid is one of the best active ingredients for vaginal dryness to look out for.
Do not use body moisturizers like hand and body creams on your vulva or inside your vagina. These can irritate the area, causing more problems.
Vaginal estrogen
If lubricants and moisturizers don’t work for you or if the primary cause of your problem is rooted in your estrogen levels, then you may need a prescribed hormonal solution like vaginal estrogen.
This is available in different forms that can be applied directly in the vagina to help restore female lubrication.
Some include:
- Tablet – is put into the vagina using an applicator once daily for the first two weeks of treatment and then twice a day until the symptoms disappear.
- Ring – is soft and flexible. You can insert it yourself or with the help of your healthcare provider. Once inserted, the ring releases a steady flow of estrogen into the vagina. You can keep it in for three months, after which it can be replaced.
- Cream – it can be put into the vagina using an applicator daily for the first one to two weeks and then a few times a week afterward.
Using estrogen can have some side effects, like breast pain and vaginal bleeding. Inform your doctor before you start using these drugs, and notify your healthcare provider if you notice any side effects.
You should not use these medicines if you:
- are pregnant or breastfeeding
- have bleeding from the vagina from an unknown cause
- have breast cancer or endometrial cancer
Ospemifene
This is an oral drug (pill) that is available on prescription. It works by acting like estrogen.
If you have vaginal dryness but do not want to go through the trouble of inserting medications into your vagina, this drug is an option you can consider and discuss with your doctor.
Ospemifene may cause some serious side effects like hot flashes, difficulty breathing, and an increased risk of forming blood clots.
In-depth studies are needed to assess the effect of long-term use and its effect on people who have breast cancer.
Dehydroepiandrosterone (DHEA)
Also known as prasterone, this drug works by mimicking the effects of estrogen on the vagina. It is a suppository that can be used for vaginal dryness caused by menopause.
Prasterone is inserted into the vagina once daily. It is a good choice for those who cannot use estrogen but can use other hormonal drugs.
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Natural remedies for vaginal dryness
If you would like to try natural remedies for vaginal dryness instead of medicines, there are a few options you can explore:
- Oils: Oils like coconut oil, olive oil, sweet almond oil, grape seed oil, and sunflower oil can be massaged around the vulva area (not in your vagina). These oils have been widely used as natural remedies for dry skin, among many other health benefits. They have emollient properties that may help to relieve vaginal dryness. Make sure you wash your hands well before applying any oil to your vulva. Also, do not use these with condoms and diaphragms, as they can damage them.
- Soy: You can try adding soy to your food. Soy contains some chemicals that may help to improve menopausal symptoms, like vaginal dryness and hot flashes. Not much evidence is available to support this.
- Lots of foreplay: Try spending more time on foreplay with your partner before penetration. This sexual stimulation can help you to get more aroused. The more aroused you get, the more wet you will become.
When should I see a doctor for vaginal dryness?
In most cases, vaginal dryness is not a sign of a life-threatening health condition. However, it can lead to discomfort and pain, which may affect your quality of life.
If the dryness is affecting your sex life or interfering with your daily activities, then it is time to talk to your healthcare provider.
If you have tried home remedies or over-the-counter medications for vaginal dryness, but it has persisted, notify your doctor.
Also, if you notice any other symptoms accompanying dryness (like heavy vaginal bleeding), contact your doctor.
FAQs
Yes, vaginal dryness is quite common. Studies show that up to 15% of women are affected before menopause, and about 40% to 57% of postmenopausal women experience vaginal dryness.
There is not much research about foods that can improve vaginal lubrication. However, eating a balanced diet is important for various aspects of health, including the health of your skin and mucous membranes, like the vagina.
Dehydration can affect many parts of your body, including your skin and vagina. If you do not have enough water in your body, you will likely be dry down there as well.
If you have vaginal dryness, you may feel sore or itchy down there. You may experience pain or discomfort during sex or during activities like walking and sitting. You may feel the need to pee more often or get recurrent UTIs.
If your vaginal dryness is a result of menopause, you may have other symptoms, such as hot flashes, insomnia, and mood swings.
Many menopausal and post-menopausal women experience vaginal dryness because of the drop in estrogen levels.
This depends on the cause of the dryness. If your dryness is caused by breastfeeding, the symptoms will resolve when you stop breastfeeding.
While breastfeeding, you can use some over-the-counter or home treatments to treat the dryness.
Vaginal dryness caused by non-estrogen factors tends to resolve once you identify and treat the cause.
However, if your dryness is caused by menopause transition or menopause, the symptoms may persist. You should seek help from your healthcare provider.
Vaginal atrophy is a common symptom in menopausal women. After menopause, your ovaries stop producing estrogen.
The low estrogen levels can cause the vagina to lose its flexibility and become thinner. This can lead to dryness and painful sex. Not all menopausal women have vaginal atrophy.
Vaginal atrophy can be treated, and symptoms can be relieved. In other words, the treatments are ways to manage it and alleviate the symptoms. However, the condition may not be completely reversed.
When there is not enough lubrication during sex, you may notice that you are dry down there. Due to friction, dryness may lead to pain (especially during penetration).
To avoid dryness and pain, make sure you have enough foreplay so that you are well aroused and wet before penetration.
If you find it difficult to get wet, try using a water-based lubricant to help ease the friction during penetration.
Conclusion
Vaginal dryness is a common condition faced by women of reproductive age but is more common among perimenopausal and menopausal women. The lack of lubrication can lead to discomfort and painful sex.
There are several causes of vaginal dryness, most of which can be treated or managed successfully at home using over-the-counter lubricants or vaginal moisturizers. If symptoms persist, you may need prescription medications.
Vaginal dryness can be an embarrassing topic to talk about for most women, but it is important to seek help from a healthcare professional if you have symptoms that you are concerned about.
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