10/05/2011 - Articles

Vaginal Dryness: Is it just you, or does everyone feel this way?

By: John Russo, Jr., PharmD

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It's not just you; 50% of American women complain of vaginal dryness (atrophic vaginitis) during and post menopause. Treatments help, and selecting the best treatment starts by understanding the problem. So, let’s start there.

The problem
Post-menopausal years come with profound changes in vaginal tissues due to lower levels of estrogen secretion. These changes result in the painful, sensitive symptoms associated with vaginal dryness. In addition, women complain of itching and discomfort during sexual intercourse. Unlike other menopausal symptoms (e.g., hot flashes, night sweats) vaginal symptoms tend to increase as women transition through menopause. In fact, they may persist for years.

Expectations
Ask a woman. She’s likely to tell you that despite the vaginal dryness, she generally feels okay about this time in her life — maybe even great. It would, however, be nice to have more (intense, frequent, unique) sexual and intimate experiences.

Women don’t want to be told they’re broken, dysfunctional, diseased, or need a cure. And that’s appropriate because women aren’t any of these things. It’s just that sometimes they need a little boost to become aroused, get in the mood, and achieve orgasm. Sex should be pleasurable, and treatment should enhance the experience — not be a distraction.

The bottom line
Post-menopausal women with diabetes are at the highest risk for vaginal symptoms. Other factors that increase this risk include poor physical function and lower body mass index. Treatments to correct these issues as much as possible start here. Other treatments for vaginal dryness are discussed in the following article.

Treatment Options for Vaginal Dryness
John Russo, Jr., PharmD

Treatments for vaginal dryness (atrophic vaginitis) fall into three categories: vaginal moisturizers and lubricants, vaginal estrogen, and lifestyle changes. Here are options along with cautions to minimize the risk of making an annoying problem worse.

Vaginal moisturizing agents and lubricants

  • Lubricants reduce friction and discomfort during intercourse
  • Apply inside the vagina or on the penis just before sex
  • Water-based vaginal lubricants (e.g., Astroglide®, KY® Silk-E) are recommended instead of general lubricants (e.g., Vaseline®), which may damage condoms and diaphragms, making them less effective in the prevention of pregnancy or sexually transmitted infections
  • Compared to lubricants, vaginal moisturizers (Replens®, Lubrin®) may provide longer relief of vaginal dryness
  • Don’t use hand and body lotions as lubricants; they may irritate vaginal tissues

Vaginal estrogen products

  • Estrogen is the most effective treatment for vaginal dryness
  • There are several options, but these products must be prescribed by a doctor
  • Dryness improves in a few weeks
  • Vaginal estrogen is safe for long-term use when monitored by you and your doctor
  • Breast cancer survivors must first discuss the risks and benefits of vaginal estrogen with their healthcare provider or oncologist

Lifestyle modifications that may reduce your discomfort

  • Stop smoking; it decreases blood flow to the vagina and reduces the response to estrogen
  • Avoid heavily scented and anti-itch products — common causes of contact or irritant dermatitis
  • Avoid harsh soaps, aggressive scrubbing, douching, and bubble baths
  • Wear loose-fitting cotton underwear
  • Drink lots of fluids
  • Reassess your need for cold and allergy medications; their antihistamine effects can cause vaginal dryness
  • Regular, unrushed sexual intercourse and other forms of sexual satisfaction (e.g., massage, extended caressing, and mutual masturbation) may help

Finally, this is not just your problem. Discuss it with your partner.

Created on: 09/12/2011
Reviewed on: 10/05/2011

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