Wellness

Vaginal Dryness During Menopause: It’s More Common Than You Think

If you’re a midlife woman, chances are you may be experiencing one of the most common symptoms of menopause: vaginal dryness.  Studies have estimated that approximately 15% of perimenopausal and up to 57% of postmenopausal women experience this condition.  So don’t worry, you’re not alone.  This is a common issue that many women face during this time in their lives.

This post is one of many that I’m doing on the symptoms of Perimenopause and Menopause.  Check out my previous posts:

Navigating Through the Fog: A Guide to Overcoming Brain Fog in Menopause

The Bloody Truth About Irregular Bleeding in Perimenopause

Hot, Bothered, and Over it: My Guide to Surviving Hot Flashes

The vagina is naturally slightly acidic, with a pH that typically ranges from 3.5 to 4.5.  This acidic environment helps to maintain a healthy balance of bacteria in the vaginal area, and helps to prevent the overgrowth of harmful bacteria and yeast.  Maintaining a healthy balance of bacteria and moisture in the vaginal area is important for overall vaginal health, and helps to prevent symptoms such as itching, burning, and discharge.

So, why does vaginal dryness during menopause happen?

Vaginal dryness during menopause is a result of the hormonal changes that occur in a woman’s body during this time.  As you approach menopause and eventually transition through, your body produces less and less estrogen.  Estrogen is a hormone that plays a crucial role in maintaining the health and vitality of the vaginal tissue.

Estrogen helps to keep the vaginal tissue hydrated, elastic, and well-lubricated.  It also helps to maintain the proper pH balance in the vagina, which helps to prevent infection and keep the vaginal tissue healthy.  Additionally, estrogen helps to keep the vaginal wall thick, which provides protection and helps to reduce the risk of injury or tearing during sexual activity.

When estrogen levels decline during menopause, the vaginal tissue can become thin, dry, and less elastic, which can lead to symptoms of vaginal dryness and other uncomfortable side effects such as itching and burning.  The lack of natural lubrication can also make sexual activity painful, which can negatively impact a woman’s sex life and overall well-being.  These symptoms can also be referred to as vaginal atrophy.

In addition to hormonal changes, other factors like age, medications, and certain medical conditions can contribute to vaginal dryness during menopause.

In short, the decrease in estrogen levels during menopause is the primary cause of vaginal dryness.  This hormonal shift leads to changes in the vaginal tissue that result in reduced natural lubrication and increased discomfort.

Are there other reasons vaginal dryness may occur?

Yes, there are other situations where vaginal dryness might happen with women at midlife.

1. Certain medications: Certain medications, such as anti-histamines, antidepressants, and anti-inflammatory drugs, can cause decreased lubrication and dryness in the vaginal area.
2. Sjogren’s syndrome: Sjogren’s syndrome is an autoimmune disorder that affects the glands that produce tears and saliva.  It can also cause dryness in the vaginal area.
3. Radiation therapy: Radiation therapy to the pelvic area can cause vaginal dryness by damaging the delicate vaginal tissue.
4. Certain medical conditions: Certain medical conditions, such as some autoimmune diseases, diabetes, and heart disease can cause decreased lubrication and dryness in the vaginal area.
5. Lack of sexual activity: Women who are not sexually active may experience decreased lubrication and dryness in the vaginal area.
6. Certain medications: Certain medications such as anti-histamines, antidepressants, anti-inflammatory drugs, and chemotherapy, can cause decreased lubrication and dryness in the vaginal area.
7. Smoking: The chemicals in cigarette smoke can damage the tissues in the vaginal walls and decrease blood flow, leading to thinning and drying of the vaginal tissues.  This can result in symptoms such as itching, burning, and painful intercourse.

 

How does vaginal dryness affect women?

Vaginal dryness can have a significant impact on a woman’s quality of life and can affect her both physically and emotionally.  Some of the ways in which vaginal dryness can negatively affect women include:

1. Physical discomfort: Vaginal dryness can cause itching, burning, and pain, which can be uncomfortable and distracting.  Women who experience these symptoms may find it difficult to focus on other tasks and activities.
2. Painful sexual activity: When the vagina is dry, sexual activity can be painful and uncomfortable and cause small tears and abrasions, and even light bleeding.  This can lead to a decrease in sexual desire and a decrease in overall sexual satisfaction.
3. Negative impact on relationships: The pain and discomfort associated with vaginal dryness can also have a negative impact on romantic relationships.  Women who experience this condition may avoid sexual activity, which can lead to feelings of frustration and resentment in their relationships.
4. Decreased self-esteem: Vaginal dryness can make women feel self-conscious and embarrassed.  This can lead to a decrease in self-esteem and overall confidence, which can impact their daily lives and relationships.
5. Increased risk of infections: When the vaginal tissue is dry, it can be more susceptible to injury and infection.  This can lead to further discomfort and the need for additional medical treatment.
6. Pain or discomfort with exercise: In some cases, women may also experience pain or discomfort during physical activity, which can limit their ability to engage in exercises or sports.  This can be especially true for high-impact activities such as running, jumping, or other high-intensity workouts.
7. Discomfort wearing certain clothing: Vaginal dryness can cause discomfort, itching, and pain, which can make wearing certain types of clothing bothersome for women who experience this condition.  Some types of clothing that may be particularly bothersome for women with vaginal dryness include:

-Tight clothing: Tight clothing, such as skinny jeans, leggings, or pantyhose, can cause friction and rubbing in the vaginal area, which can worsen symptoms of dryness and discomfort.
-Synthetic fabrics: Synthetic fabrics, such as polyester, can cause irritation and itching in the vaginal area and can exacerbate symptoms of dryness.
-Thongs: Thongs can cause rubbing and chafing in the vaginal area, which can worsen symptoms of dryness and discomfort.
-Wet clothing: Wearing wet clothing, such as a swimsuit or workout clothes, for an extended period of time can make dryness and itching worse.

It’s important to know that vaginal dryness can affect more than just your sex life.  The good news is that there are treatments available that can help.

Choosing a lubricant or moisturizer to manage vaginal dryness:

It’s important to choose the right vaginal lubricant or moisturizer during menopause.  To achieve optimal results, it’s recommended to select a product that is well-balanced in terms of both its osmolality and pH.

Osmolality refers to the concentration of particles in a solution.  A lubricant with a low osmolality is recommended as it is less likely to cause irritation or discomfort in the vaginal area.

pH refers to the level of acidity or alkalinity in a solution.  A lubricant with a pH that is similar to natural vaginal secretions is recommended as it helps to maintain a healthy balance of bacteria in the vaginal area.

Having a vaginal lubricant or moisturizer that is physiologically similar to natural vaginal secretions is necessary because it helps to maintain the delicate balance of the vaginal environment and prevent further irritation or discomfort.  An optimally balanced product will not only provide temporary relief from symptoms of vaginal dryness, but also help to support the overall health of the vaginal tissue.

One option is over-the-counter lubricants.  These can provide only temporary relief and make having sex more comfortable.  There are some lubricants that are longer lasting that adhere to the vaginal wall and don’t have to be applied as often- 3-4 times per week usually.

Vaginal lubricants that are water-based are generally recommended as they are less likely to cause irritation or discomfort in the vaginal area.  However, some women may find that silicone-based lubricants are more effective, while others may prefer oil-based lubricants.

Another option is vaginal moisturizers, which are meant to be used on a regular basis to help replace and maintain moisture in the vagina, as well as help heal dry and atrophied tissue.  Vaginal moisturizers come in several forms, including creams, gels, and suppositories and are applied less frequently, and last for a longer period.  Some products contain natural ingredients, such as aloe vera or coconut oil, which can help to soothe and hydrate the vaginal tissue.  Other products may contain water-based or silicone-based ingredients and hyaluronic acids that help to provide long-lasting hydration.

It’s important for women to talk to their healthcare providers about their individual needs and preferences when choosing a vaginal lubricant or moisturizer.  Some women may be more sensitive to certain ingredients, so it’s essential to choose a lubricant that is free from harsh chemicals, fragrances, and dyes.

The recommendation to use vaginal lubricants and moisturizers on their own or in combination with other treatments, such as systemic or topical hormone replacement therapy, depends on each individual woman’s specific needs and medical history.  Some women may benefit from using lubricants or moisturizers alone, while others may need a more comprehensive approach that includes hormone replacement therapy.

If these options don’t work for you, your doctor may recommend low-dose vaginal estrogen.  This type of treatment can help to restore natural moisture and improve the overall health of your vaginal tissue.  Your physician may also choose to recommend an alternate form of estrogen if you have other Menopausal symptoms that you are also bothered with, which can be effective.

Selective estrogen receptor modulators (SERMs) and the use of certain laser technologies are also being studied hand have shown potential to manage extreme cases of vaginal dryness.

There is also some evidence that supplementation of Vitamin D may help improve the symptoms of vaginal atrophy.

It’s also important to make lifestyle choices that can help reduce vaginal dryness.  This includes staying hydrated, avoiding irritants like harsh soaps, and using a gentle, fragrance-free laundry detergent for your clothes and linens.

Estrogen is a crucial hormone that has a profound impact on the health and wellbeing of women, including the health of the vaginal tissue.  When estrogen levels decline during menopause, the effects can be significant and can greatly impact a woman’s quality of life.  It’s important for women to work closely with their healthcare providers to determine the best approach to managing estrogen levels and maintaining vaginal health during this time.

With the right treatment and care, you can feel comfortable and confident in your own skin.  If you’re experiencing symptoms, don’t hesitate to talk to your doctor about the best options for you.

If you want more information about the many symptoms of Perimenopause and Menopause check out my post What to Expect in Perimenopause and Menopause- 75 Symptoms!

This blog post is for informational purposes only and is not intended to replace the advice of any healthcare professional.  If you have any concerns about your health, it is important to consult a healthcare professional.  Although I am a Registered nurse, I am not your nurse and the information provided in this blog post is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  I am not responsible for any actions taken based on the information provided in this blog post.  Please see my disclaimer here for more information.

Take care,

Celebrate Life in the Middle Blog

 

 

 

 

 

 

Resources:
Edwards, D., & Panay, N. (2016). Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition?. Climacteric, 19(2), 151-161.
Waetjen, L. E., Crawford, S. L., Chang, P. Y., Reed, B. D., Hess, R., Avis, N. E., … & Gold, E. B. (2018). Factors associated with developing vaginal dryness symptoms in women transitioning through menopause: a longitudinal study. Menopause (New York, NY), 25(10), 1094.
Archer, D. F., Simon, J. A., Portman, D. J., Goldstein, S. R., & Goldstein, I. (2019). Ospemifene for the treatment of menopausal vaginal dryness, a symptom of the genitourinary syndrome of menopause. Expert Review of Endocrinology & Metabolism, 14(5), 301-314.
Cagnacci, A., Barattini, D. F., Casolati, E., Pecoroni, A., Mangrella, M., & Patrascu, L. C. (2022). Polycarbophil vaginal moisturizing gel versus hyaluronic acid gel in women affected by vaginal dryness in late menopausal transition: A prospective randomized trial. European Journal of Obstetrics & Gynecology and Reproductive Biology, 270, 239-245.
Angelou, K., Grigoriadis, T., Diakosavvas, M., Zacharakis, D., & Athanasiou, S. (2020). The genitourinary syndrome of menopause: an overview of the recent data. Cureus, 12(4).
Paraiso, M. F. R., Ferrando, C. A., Sokol, E. R., Rardin, C. R., Matthews, C. A., Karram, M. M., & Iglesia, C. B. (2020). A randomized clinical trial comparing vaginal laser therapy to vaginal estrogen therapy in women with genitourinary syndrome of menopause: The VeLVET Trial. Menopause, 27(1), 50-56.
Mili, N., Paschou, S. A., Armeni, A., Georgopoulos, N., Goulis, D. G., & Lambrinoudaki, I. (2021). Genitourinary syndrome of menopause: a systematic review on prevalence and treatment. Menopause, 28(6), 706-716.
Cagnacci, A., Venier, M., Xholli, A., Paglietti, C., & Caruso, S. (2020). Female sexuality and vaginal health across the menopausal age. Menopause, 27(1), 14-19.
Riazi, H., Ghazanfarpour, M., Taebi, M., & Abdolahian, S. (2019). Effect of vitamin D on the vaginal health of menopausal women: a systematic review. Journal of Menopausal Medicine, 25(3), 109-116.

 

 

 

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