Vaginal dryness -- What is it, what causes it, what can you do about it and will it go away?

Vaginal dryness is a very common condition. It can affect women of various ages, but most often vaginal dryness occurs during and after menopause. In all, 10-40 percent of menopausal women have signs and symptoms of vaginal dryness. Aside from vaginal dryness other symptoms include: itching and burning, a feeling of pressure, pain or light bleeding after sexual intercourse, and urinary frequency or urgency. Vaginal dryness is caused by a variety of conditions.

Causes of dryness

The main cause is reduced estrogen levels. Estrogen keeps the vaginal cells healthy by regulating lubrication, elasticity and acidity. This created a natural defense against vaginal and urinary infections. As your levels decrease, so does this natural defense. Estrogen levels can fall for a variety of reasons: menopause, childbirth, breast feeding, medications (including some allergy medicines, antidepressants and hormone modifiers), certain diseases, cigarette smoking and surgical removal of your ovaries.

Diagnosis

A physician may perform a pelvic exam to evaluate and diagnose vaginal dryness. Often times a cellular sample from the vagina is evaluated by a microscopic exam to look for vaginal atrophy (or dryness). Once the diagnosis is made there are a variety of treatment options. Some self-care options include over-the-counter products such as sexual lubricants (K-Y, Astroglide) and natural alternatives (vitamin E oil, olive oil) which last a few hours and aid during intercourse, or moisturizers (Replens, Lubrin) which moisturize that delicate skin for up to three days with a single application. Such moisturizers also help keep the pH of the inside of the vagina at the right level, helping to fend off infections. (Note that petroleum-based lubricants like Vaseline can destroy latex and cause condoms and diaphragms to break.)

Prescription vaginal estrogen therapy

Another course of treatment, when the dryness is due to inadequate estrogen, is using prescription vaginal estrogen therapy. This therapy comes in 3 forms: estrogen cream (Estrace, Premarin), an estrogen ring (Estring) or an insertable vaginal tablet (Vagifen). If the vaginal dryness is due to menopause, and associated with other symptoms, your physician may discuss oral estrogen pills or patches to help with the constellation of menopausal symptoms including hot flashes. Avoiding vinegar and other douches, bubble baths, and harsh soaps can also help.

Vaginal dryness and sex

As you become aroused, blood flow increases to the vagina and surrounding tissues, helping the area to stretch. In addition, your body naturally self-lubricates to make intercourse possible -- and pleasurable. However, if our partner is too quick, begins to try to have intercourse before we have relaxed and become lubricated, we are likely to feel dry. A big inhibitor of lubrication and interest is insecurity or worries If you have ever experienced painful sex, there is an unconscious part of you that will try to guard against a repeat performance. Using diaphragms may also lead to dryness because they can block the downward flow of the vaginal secretions from the cervix and upper vagina.

Prognosis

Finally, you asked if the vaginal dryness will go away and this depends on its cause; if the cause is a temporary situation, such as childbirth or breastfeeding, your body will return to its normal state. If the condition is not temporary it will not resolve without some sort of appropriate intervention.

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