Common Causes of Vaginal Dryness

I’ve noticed a real disconnect lately in the world of vaginal health, specifically as it relates to menopause. Seems most women associate menopause with one obvious symptom, hot flashes. These pesky flushes, accompanied by irregular bleeding habits, are often the first clues that something is up hormonally, and change is coming.

In fact, while hot flashes and wonky menses are iconic perimenopausal symptoms, another super common complaint often takes women by surprise — it’s “vaginal dryness” — in medical terms, vaginal atrophy or genitourinary syndrome of menopause (GSM). This condition encompasses a collection of uncomfortable symptoms including vaginal dryness, burning, and painful sex. There’s often a disconnect with menopause because symptoms of vaginal dryness are often vague but broad, while still being both chronic and progressive.

Why Vaginal Dryness Happens

Less estrogen during menopause means less blood flow to the vagina. And less blood flow to the vagina typically means less natural lubrication, making this a main cause of vaginal dryness. Common signs of vaginal dryness include vaginal tissue changes, such as vulvovaginal tissues becoming thinner, less elastic, more delicate, and more prone to injury, especially during intercourse. The vagina may even shrink in length and width over time due to less estrogen, and vaginal tissues may become dry and sore.

Causes of Vaginal Dryness

Vaginal dryness isn’t just limited to women in the menopause crowd. In addition to hormonal causes of vaginal dryness, other common causes of vaginal dryness can include:

• Smoking: This habit is not vagina-friendly; it causes blood vessels to constrict. The result is diminished blood flow, including to the vagina, which negatively impacts the creation of natural lubrication and can increase the symptoms and severity of vaginal dryness.
• Birth control pills: These may also be a cause of vaginal dryness. They work by suppressing ovulation and the hormone surges that are associated with it, which can lead to vaginal dryness and its associated symptoms in some women.
• Antihistamines: These may dry up more than just your nasal passages — they can affect numerous mucus membranes in the body, including the vagina. If you routinely take an antihistamine, you may experience dry vaginal skin and drier vaginal tissues.
• Surgery: Including the removal of ovaries or a total hysterectomy, may influence vaginal health and lead to vaginal dryness, vulvar atrophy, and other disruptive physical changes to vulvovaginal tissues.
• Certain medications: Some medications can potentially interrupt the creation of natural vaginal lubrication, causing vaginal dryness and soreness.

Treating Vaginal Dryness in Menopause

There are clear and impactful physical and emotional consequences of struggling through vaginal dryness without seeking treatment.

Women may experience pain or even bleeding during sex due to vaginal dryness. This can impact self-confidence and a woman’s sense of femininity. Effects on intimacy and relationships over time can be significant and may negatively impact daily quality of life.

Vaginal infections, including yeast and bacterial vaginosis (BV), might result from untreated vaginal dryness. Vaginal itching, irritation, and changes in vaginal scent may also occur.

Optimal vaginal health is directly related to a delicate balance of organisms and bacteria that make up the vagina’s natural microbiome. Lactobacilli are responsible for maintaining a healthy acidic vaginal pH, and less estrogen during the menopause transition can lead to pH changes and symptoms of infection or imbalance.

Vaginal dryness also often leads to urinary complaints, including urgency, frequency, and a proclivity to urinary tract infections (UTIs).

For a brief video from Bonafide’s Chief Medical Officer, Dr. Alyssa Dweck, on solutions for vaginal dryness during menopause, see below:

Vaginal Dryness, A Common Menopause Symptom

Did you know that 1 in 2 menopausal women display symptoms of vaginal dryness? Shockingly, one study suggests only 50% of women with symptoms receive treatment.¹ Oftentimes, women don’t bring up the issue of vaginal dryness with their healthcare providers and vice versa. In addition, many women are unaware treatments for vaginal dryness are available, or perhaps they aren’t happy with the options offered.

Talk to Your Healthcare Provider If You’re Experiencing Vaginal Dryness

Whether it’s an as-needed, over-the-counter lubricant for sex, a regularly used moisturizer such as Revaree^® Plus with hyaluronic acid, vaginal estrogen replacement, or other pharmaceutical solutions, a little TLC goes a long way in maintaining vaginal health and addressing symptoms.

Remember, hormone-free treatment options can be used to address vaginal dryness symptoms safely over the long term. Being proactive and consistent with treatment can help reduce signs and symptoms during menopause and beyond.

Resources

1. Kingsberg SA, Krychman M, Graham S, Bernick B, Mirkin S. The Women’s EMPOWER Survey: Identifying women’s perceptions on vulvar and vaginal atrophy and its treatment. J Sex Med. 2017;14:413–424.