Vaginal Dryness - The Silent Symptom

It wasn’t that long ago we wouldn’t have dared say the word “menopause” out loud. We’re still not shouting it from the rooftops, but we have gotten to a point where we can at least share our best tips for dealing with hot flashes and kvetch across our yoga mats about how our husbands just don’t get it.

But there’s still one menopause symptom that we keep hidden from the light of day – vaginal dryness. Ugh. Nobody wants to talk about it, but we all know what it’s like to deal with it. So grab your smartphone, or tilt your laptop screen away from your coworker, and let’s get busy.

The Silent Symptom

Normally your vaginal walls are coated with a thin layer of moisture. The hormone changes of menopause can wreak havoc on your vagina, causing thinning and inflammation of the vaginal walls and changes in the amount and consistency of this lubricating fluid. Under normal, everyday circumstances this can mean dryness, itchiness, and irritation, and during sexual intercourse you may experience discomfort and pain, or difficulty getting aroused in the first place.1

Emotionally, these symptoms can take their toll – in addition to the physical discomfort, you might feel depressed and discouraged and both your own self-esteem and your relationship with your partner could suffer. This is a big deal – and now that we’re talking about it, there are things that can help.

The first thing to do is to avoid irritants and chemicals as much as possible. Use only clean water to wash the inner parts of your vulva and avoid soaps or perfumed lotions or douches. Avoid coloured or scented toilet paper and wash your underwear using scent-free detergent with no fabric softeners.

Now that you’ve removed all the irritants you can from the equation, it’s time to consider your options, which range from natural, non-prescription moisturizers and lubricants to prescription low-dose hormonal options.

Moisturizers

Vaginal moisturizers are used to maintain vaginal moisture and acidity, reducing everyday symptoms of irritation and burning. Moisturizes are applied regularly and are absorbed into the skin and vaginal wall, mimicking natural vaginal lubrication. Moisturizers are widely available in drugstores and don’t require a prescription. Some examples are: Fresh Start, K-Y Silk-E, Moist Again, Replens, K-Y Liquibeads

Lubricants

If your vaginal dryness is an issue primarily during sex, water- or silicone-based vaginal lubricants may be the answer. These come in liquid or gel form and are applied to the vagina and vulva (and to toys or your partner’s penis, as desired) to provide lubrication and reduce friction. Unlike moisturizers, lubricants are not absorbed into the skin. Lubricants are widely available in drugstores, sex shops, or online. Oil-based lubricants are not recommended as they can break down latex condoms, increasing your risk of STIs, and can leave a coating that can increase your risk of bacterial infections.2 Some examples of lubricants are: Astroglide, FemGlide, Just Like Me, K-Y Jelly, Pre-Seed, Summer’s Eve (water-based); ID Millennium, Pink, Pjur, Pure Pleasure (silicone-based).

Many women who have mild to moderate vaginal discomfort and pain during intercourse will find effective relief from non-prescription moisturizers and lubricants. For both moisturizers and lubricants, you may need to experiment with several products to find the one that’s best for you.3

Low-Dose Vaginal Estrogen

 

If your vaginal dryness and pain is more severe or doesn’t respond to moisturizers and lubricants, you should talk to your healthcare provider, who may want to investigate the cause. They may recommend a low-dose prescription vaginal estrogen product. These come in tablet, cream, or ring form and deliver estrogen directly to the vagina, helping to restore vaginal tissue thickness and flexibility. Some examples of prescription vaginal estrogen therapy products are Vagifem (vaginal tablet), Estrace (cream), Neo-Estrone (cream), Premarin (cream), Estring (low-dose vaginal ring). You may also continue to use lubricants and moisturizers as needed. Tell your health care provider if you have been treated for breast cancer so they can properly assess the risks and benefits of hormone therapy.3

If you are having other severe menopause symptoms in addition to vaginal dryness and irritation, your doctor may suggest higher-dose hormone therapy that raises estrogen levels throughout the body.

It’s no joke that menopause can wreak havoc on your physical and emotional well-being, not to mention your relationship with your loved ones. This is one area where relief is possible – and relatively simple – if we can just bring ourselves to talk about it.

References:

  1. “Vaginal dryness.” http://www.mayoclinic.org/diseases-conditions/vaginal-dryness/basics/definition/con-20029192. Retrieved September 21, 2015.
  2.  “Choosing a personal lubricant.” http://www.everydayhealth.com/sexual-health/choosing-personal-lubricant.aspx. Retrieved September 21, 2015.
  3. Vaginal and vulvar comfort: Lubricants, moisturizers and low-dose vaginal estrogen,” http://www.menopause.org/for-women/sexual-health-menopause-online/effective-treatments-for-sexual-problems/vaginal-and-vulvar-comfort-lubricants-moisturizers-and-low-dose-vaginal-estrogen. Retrieved September 21, 2015.

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