Women’s bodies make lubrication to allow comfort with penetration during intercourse. Moisture keeps the vagina chemically balanced and free of bacteria. There is more moisture present in the vagina around ovulation, during pregnancy and with sexual arousal.
Vaginal dryness is common in women who have gone through menopause.
A decrease in estrogen levels caused by menopause, breastfeeding or just after menstrual cycles can cause vaginal dryness. Vaginal atrophy from low estrogen levels increases the risk of bladder irritation, overactive bladder and infections. Also, anything that decreases blood flow to the pelvic organs can cause vaginal dryness.
Decreased blood flow can occur from: atherosclerosis, hypertension, high cholesterol, and smoking. Smoking causes constriction of blood vessels, decreases estrogen and levels of HDL (good cholesterol).
Pelvic surgery or trauma can damage nerves and blood vessels and can contribute to dryness. Other examples of trauma which can cause vaginal dryness include: pelvic or lower spinal fractures, falls, accidents and the pressure caused by prolonged bike riding.
Some studies show that when a hysterectomy preserves the cervix, sexual function is not compromised as much. This seems to be due to the large number of nerves and blood vessels around the cervix that are not damaged. Another medical procedure includes uterine embolization which is done to block the blood supply to the uterus which can decrease blood flow to the vagina causing vaginal dryness.
- Long-standing diabetes, some antibiotics, tamoxifen (a drug used to treat cancer), and birth-control pills can affect lubrication.
- Taking Paxil can cause loss of libido, dryness and a side effect can include difficulty reaching orgasm.
- Gonadotropin-releasing hormone used to treat endometriosis can cause problems with lubrication.
- Health conditions such as disorders of the pituitary gland, thyroid or adrenals affect the hormones and lubrication of the vagina.
Blood tests can determine if a person has low levels of the hormones estrogen and testosterone.
Clinical signs & symptoms of vaginal dryness
Pain with sex, itching, irritation, burning.
Discomfort from chemical irritation caused by soaps, powders, perfumes, fabrics can occur. Try to avoid tight clothes.
Yeast infections and vulvodynia can cause some of the same symptoms. See your doctor for a complete diagnosis for the cause of your vaginal dryness.
Secondary problems and complications
Often the symptoms are treated with the wrong medications. Many women try treatments for yeast infections without success. This makes sense because the symptoms are from a decrease in hormone levels rather than an infection.
Relationships suffer when the woman experiences vaginal dryness and self-esteem of the woman can be negatively impacted. Many women endure painful sex thinking there is nothing that can be done about it.
The vagina can become narrower with a lack of estrogen. The tissues become thin and fragile.
A lack of both estrogen and testosterone cause vaginal dryness.
Poor blood supply, damaged nerves, scar tissue all contribute to the problem.
Many things can be tried to help vaginal dryness. Both testosterone and estrogen help.
Estrogen comes in the form of creams, gels, rings, or tablets.
Vagifem is the tablet that is inserted into the vagina to deliver estrogen to the tissues that need it the most. A word of caution: estrogen from the Vagifem tablet can be absorbed by the man’s penis during sex, causing him to absorb too much estrogen which can cause him to have sexual dysfunction. Please talk to your doctor about the risks involved with Vagifem for your husband/partner.
Over the Counter Treatments
- Different lubricants, some suggestions are: Slippery Stuff, Neueve, Yes, Yes, Yes, Vitamin E oil, neogyn soothing cream, Lubriessence a lubricant by goDesana, VMagic.
- Avoid oil-based lubricants such as baby oil or Vaseline as they promote bacterial and yeast infection in the vagina.
- Astro glide, KY Jelly, and many other lubricants found in drug stores, contain a chemical that irritates vaginal tissues.
- Hyaluronic Acid supplements can help.
- Foods and herbs that can help include: soy milk, soy nuts, soy flour, green soy beans, Mexican wild yam, flaxseed,
- lima beans, kidney beans, chick peas, lentils and seaweed, red clover and black cohosh, as they contain some estrogens.
- Regular sex improves blood flow to the area and reduces atrophy. Manual stretching keeps the vagina elastic. (Consider working with a pelvic floor physical therapist to ensure you are stretching the pelvic floor muscles correctly.)
- Dilators are a useful tool for stretching the tissues.
- Viagra, not yet approved for women, but appears to increase blood flow to the area, and increase lubrication and sensation.
Educate yourself, try the things that make sense to you, talk to your doctor about treatment options, ask for a referral to a Physical Therapist who specializes in pelvic floor dysfunction, read the books highlighted in the Biblography at the end of this article. There is information out there if you search for it.
“Ever Since I Had My Baby” by Roger Goldberg, MD
“For Women Only” by Jennifer Berman, MD & Laura Berman, PhD
“A Gynecologist’s Second Opinion” by William H. Parker, MD
Beverly Helm, PT, received an Associates Degree in Physical Therapy from Tulsa Junior College and her Bachelors Degree in Physical Therapy from the University of Health Sciences, Antigua, West Indies. Over the past twenty years she has treated home health and nursing home patients in Colorado, Oklahoma, Wyoming, and Missouri. In the past five years she has taken many hours of continuing education to learn about pelvic floor dysfunction. Originally from New Mexico, Beverly now lives in Colorado with her husband and is the mother of two grown children.
For questions about vaginal dryness or any of the conditions outlined in this article, feel free to email firstname.lastname@example.org with the subject line ‘Vaginal Dryness’.