Vaginal dryness is a common problem for women
during and after menopause. In fact, four out of every ten women experience
vaginal dryness at the menopausal age. Reports reveal that 50% of women between
forty and sixty years of age are confronted by vaginal dryness, though
occasionally.
Vaginal dryness is medically described as
'atrophic vaginitis' which is lack of adequate moisture in the vaginal area.
Women who suffer vaginal dryness very often dread to have intercourse and they
avoid sex as a result. This is mainly due to the fact that lack of vaginal
lubrication can make intercourse painful. Consequently, women suffering from
vaginal dryness also experience a drop off in libido.
The amount of vaginal lubrication
is bound to vary from one woman to another. The vaginal fluid itself is clear
and odorless. Not many women notice the vaginal fluid most of the time other
than when they are sexually aroused.
As John Grossman MD, a gynecologist at the George
Washington University Hospital and Medical Center in Washington DC comments:
'The vagina wasn't designed to be sterile; It has its own biologically normal,
natural method of bacterial control- mainly by maintaining a natural level of
acidity'.
Causes for vaginal dryness
A variety of conditions can cause vaginal dryness. Potential
causes include:
- Decreased estrogen levels can be construed as the
most prominent cause for vaginal dryness. Estrogen is a female hormone
that helps to maintain normal vaginal lubrication, renders tissue
elasticity and acidity. When estrogen level decreases, the natural defense
declines leading to thinner and less elastic vaginal lining combined with
dryness of the vagina.
- Menopause or perimenopause is one of the reasons
for fall in estrogen levels.
- Childbirth, breast feeding and surgical removal of
ovaries, cancer therapy, immune disorders and even cigarette smoking are
other factors that lead to decline in estrogen.
- Certain allergies to medications such as
antidepressants decrease the moisture in various parts of the body
including the vagina. Anti estrogen medications administered for cancer
treatments and medications for treatment of ulcer, high blood pressure
also contribute to vaginal dryness.
- Sexually transmitted diseases, vaginal trauma and
malignant and benign tumor could be other factors for vaginal dryness.
- An auto immune disease called Sjogren's syndrome
which attacks healthy tissues is seen to cause vaginal dryness.
- The practice of cleansing the vagina with a liquid
preparation, douching, can disrupt the normal chemical balance and cause
inflammation. This can also result in vaginal dryness. In perimenopausal
women and menopausal women particularly in those undergoing hormonal
replacement therapy, vaginal dryness is more acute. It is in fact one of
the top ten problems afflicting menopausal women.
- In postpartum women, higher stress levels are
correlated with vaginal dryness.
- Elevated levels of stress due to pressures and
demands at work, family and financial issues in this fast paced hectic
life style are leading contributory factors.
Signs and symptoms of vaginal dryness
The common signs and symptoms of vaginal dryness include
- Dryness
- Itching and stinging around the vaginal opening
- Burning sensation
- Pain
- Mild bleeding and discomfort during intercourse
- Urgency and frequency of urination
Diagnosis of vaginal dryness
A doctor or a gynecologist
normally takes a health history of the patient and finds out how long she has
been experiencing these symptoms of burning, itching and discomfort in the
vaginal area. Other factors such as douching or medications are examined. The
doctor does a pelvic exam, checking the vagina for thinning or redness and
rules out possible other causes for discomfort including urinary tract
infection. Sometimes, Pap test is done to remove the cells from the vaginal
wall or cervix for testing.
Treatment options for vaginal dryness
Vaginal dryness during perimenopause and menopause is almost inevitable. By and large, vaginal dryness
is caused by hormonal imbalance. If vaginal dryness is caused by low levels of
estrogen, then estrogen replacement therapies should help. Estrogen therapy can
be administered by skin patch, vaginal cream or directly into the vagina or as
oral supplement.
There are three types of vaginal estrogen used commonly in
most women:
- A doctor could insert a vaginal estrogen ring
'Estring' which is soft and flexible ring into the vagina. This releases a
steady stream of estrogen directly to the vaginal tissues. The ring should
be replaced once in three months.
- Vaginal estrogen tablets are inserted into the vagina
using a disposable applicator once a day. After a few weeks of treatment,
the tablets can be inserted twice a week and gradually stopped.
- Vaginal estrogen creams are applied to the vagina
using an applicator, daily for the first few weeks and then one to three
times a week.
There are proven methods that can
help increase natural biological production of the bodily fluid necessary for
vaginal lubrication. Some natural and safe approaches to alleviate vaginal dryness
include the following measures:
- A best solution to combat vaginal dryness is to boost
water intake. It is necessary to check one's hydration and consume at least
eight to ten eight ounce glasses of water a day. This is a simple yet
surprisingly helpful step.
- It is found that many of the personal bathing and
laundry products contain perfume and other chemicals which can irritate
the delicate mucosal tissues that line the vagina. It becomes therefore
imperative to review the list of ingredients in such products before
actually using them. Alternatively, a super fatty hypoallergenic soap with
no dyes or fragrances and one that is non alkaline with pH balance
maintained is recommended.
- The estrogen which is needed for vaginal lubrication
is made from cholesterol. Many women who consume low-fat, high-carb diets
severely lack cholesterol and essential nutritional intake which produce
sex hormones. It is therefore essential to give the body the support it
needs to balance the hormones. For instance, soy and flax seed are good
source of phyto estrogens.
- It is advised not to use vinegar, yogurt and hand
lotions, soaps and bubble baths to relieve discomfort of vaginal dryness
as these could simply irritate the vagina and lead to serious infections.
- It should be worthwhile to find medical-grade
top-quality multivitamin and mineral supplements which can cover the
missing gaps in natural nutritional diets.
Making changes in lifestyle and
environment such as switching to fragrance free personal products, lighter scented
perfumes, eating a regular balanced diet, supplementing with multiple vitamin
and mineral support, can bring the much needed relief for vaginal dryness.
Other treatment methods for vaginal dryness
- Sometimes a personal lubricant can prove to be effective
and provide immediate relief from vaginal dryness. This can be tried while
waiting for improved hydration, nutrition and endocrine support. There are
wide ranges of formulations available which are safe for use in this
sensitive part of the body. For example, vitamin E vaginal suppository is
found to work extremely well.
- A healthcare practitioner would also suggest locally
released bioidentical estrogen replacement therapy in the form of estriol
vaginal cream or progesterone creams that could prove effective.
- Some gynecologists offer a practical solution to
combat vaginal dryness to enable sexual intercourse more comfortable. Try
dipping a finger into the vagina and drawing some of the lubrication out
to coat the dry surface, they suggest. This way, the moisture that may
pool in the back of the vagina in a laid back position can be brought
forward. In case the dryness is only occasional, a water based lubricant
can be used during sexual intercourse.
- Many doctors opine that having sex on a regular basis
is a natural way to make for more vaginal lubrication; continuing sexual
activity is an important help in holding back the thinning and drying
effects of menopause on vaginal tissues.
- In addition to the above physical issues, it is of
utmost importance to assesses the emotional state, and evaluate depression
or stress levels as these can cause havoc to the natural production of
vaginal lubrication.
Yet one cannot expect miraculous results instantly and
it would require a couple of weeks for treatment methods and remedies to work
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