What Is Vaginal Dryness? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Vaginal dryness occurs when the tissues of the vagina are not well lubricated and healthy. It can occur at any age but is more common in older women. You may notice:

• Pain or discomfort during penetrative sexual intercourse
• Light bleeding after intercourse
• Soreness, itching, or burning of the vagina
• Mild vaginal discharge

A number of factors may contribute to vaginal or genital dryness.

Low Estrogen Vaginal dryness is most often caused by a decrease in estrogen levels. Estrogen is a hormone that helps keep the tissues of your vagina lubricated and healthy. Many factors can cause estrogen depletion: (1)

• Menopause or perimenopause
• Childbirth
• Breastfeeding
• Smoking
• Surgical removal of the ovaries
• Chemotherapy and radiation in the pelvic area
• Anti-estrogen medications
• Cancer therapy
• Severe depression and stress

Douching and Other Irritants Certain soaps, lotions, perfumes, and douches can disrupt the natural balance of chemicals in your vagina, leading to dryness. Also, some tampons and condoms can cause irritations. (2)

Other Medications Allergy, cold, and asthma medicines that contain antihistamines can have a drying effect on the body and contribute to reduced vaginal lubrication. (2) Certain antidepressants may also lead to a reduction in vaginal secretions. (3)

Sjogren's Syndrome The autoimmune disease known as Sjogren's syndrome can cause dryness in the eyes, mouth, and vagina. (4)

Visit your doctor if you have symptoms of vaginal dryness that are severe or don't go away. Your healthcare provider will ask about symptoms and medications you take, and may perform the following tests: (5)

• Pelvic exam to determine whether the walls of your vagina are thin, pale, or red
• Blood test to check hormone levels and for other issues that might be a cause
• Test of vaginal discharge to check for other causes of dryness

Prognosis of Vaginal Dryness

Vaginal dryness is often undertreated because so many women are too embarrassed to address the issue with their healthcare provider. Only one-quarter of women with the issue actually seek treatment. If not addressed, vaginal dryness can severely impact quality of life. However, the issue is easily corrected with proper treatment. (6)

There are various ways to treat vaginal dryness, depending on its cause:

 Medication Options

• Topical Estrogen Available as a tablet, cream, vaginal suppository, or ring that's placed directly into the vagina, it can alleviate symptoms of vaginal dryness. (7)
• Osphena (ospemifene) This estrogen agonist-antagonist is the only oral product approved by the U.S. Food and Drug Administration for the treatment of vaginal dryness and moderate to severe dyspareunia (painful sex). (8 PDF) It is not recommended for people with breast cancer or those at a high risk for it. (7)
• Intrarosa (dehydroepiandrosterone) This vaginal suppository can help alleviate painful sexual intercourse. (7)
  

Lubricants and Moisturizers

• Vaginal moisturizers (such as Replens, Lubrin, Sylk, and vitamin E vaginal suppositories) are to be used regularly, regardless of whether you have sexual intercourse or not. Read the product labels carefully: Paraben, glycerin-free, and propylene glycol ingredients can be irritating to your skin. (9)
• Vaginal lubricants are used just prior to penetrative sexual intercourse. (7) Water-based products with glycerin include Astroglide, Luvena, K-Y Jelly, and Vagisil. Those without glycerin, which may irritate some women, include Isabel Fay. Carrageenan-based products are also glycerin-free. Silicone-based products (K-Y True Feel Premium, Swiss Navy, and Wet Platinum) are safe to use with condoms.

Alternative and Complementary Therapies

• Regular sexual stimulation and activity, with a partner or alone (masturbation), can help keep tissue in the vagina moist and promote healthy vaginal tissue. (7)
• Talk with your healthcare provider about the safety of topically applied natural oils, such as coconut, olive, or sweet almond oils. (These may not be the best option if you’re concerned about STIs, however, as these oils can destroy condoms.) (9)

Prevention of Vaginal Dryness

You can prevent or minimize vaginal dryness by:

• Having regular sexual activity (7)
• Not using douches, perfumes, or deodorants in or near your vaginal area and washing only with perfume- and dye-free soaps (6)
• Allowing more time for foreplay before sex to arouse and stimulate yourself, which will increase vaginal secretions (6)

Vaginal dryness can lead to:

• Painful sexual intercourse
• Low sexual desire
• Bacterial or yeast infections

Here are the numbers:

• It's estimated that about 50 percent of menopausal women experience vaginal dryness. (10)
• It's possible that as many as 90 percent of those women don't seek medical help. (10)
• Between 17 and 45 percent of menopausal women say they find sex painful due to vaginal dryness and thinning of vaginal tissue. (11)
• Approximately 17 percent of women ages 18 to 50 have problems with vaginal dryness during sex, even before menopause occurs. (6)

These conditions are related to vaginal dryness:

• Menopausal genital and urinary symptoms, collectively known as genitourinary symptoms of menopause (vaginal dryness, burning and irritation, painful sex, and urinary issues)
• Sjogren's syndrome
• Urinary tract infections

American College of Obstetricians and Gynecologists

The premier professional membership organization for board-certified obstetrician-gynecologists, the organization also provides educational information to the public.

North American Menopause Society

The organization describes itself as “devoted to promoting women’s health at midlife and beyond.” It can provide lots of information on vaginal dryness and help you find an appropriate healthcare provider.