Vaginal dryness can result in discomfort or pain in your vaginal area when sitting, exercising, urinating, or even during sex, which is never a pleasant experience. Many women, however, may experience one or more of these symptoms as their hormones fluctuate throughout different times in their lives. These hormonal changes may cause the vagina to lose moisture and become less flexible, leading to a variety of symptoms, including vaginal dryness.
Vaginal dryness, also known as atrophic vaginitis or vaginal atrophy, may first occur when pregnant or when breastfeeding, due to a shift in hormones. It may happen again later in life as the menopause transition begins–and could continue into postmenopause.1
While vaginal dryness during menopause can affect your quality of life, it’s important to know that solutions are available to help ease discomfort and assist in managing any pain or irritation you may be experiencing. Let’s take a closer look at why vaginal dryness is so common during menopause, and what you can do to manage it.
What Are the Symptoms of Vaginal Dryness?
Some women first experience vaginal dryness in perimenopause, with as many as one in three women dealing with it during and after the menopause transition.2 “Vaginal dryness is something that many of my patients start struggling with at some point in their mid to late 40's,” says Dr. Rebecca Levy-Gantt, DO. “They complain of irritation, discomfort, pain with intercourse, as well as an increase in urinary tract infections and bladder irritability.” Additional symptoms of vaginal dryness may include a burning sensation as well as itching.
Hear more from Bonafide Chief Medical Officer, Dr. Alyssa Dweck, about what vaginal dryness is during menopause, below:
Why Does Vaginal Dryness Happen in Menopause?
Estrogen decline–the reason for many menopausal symptoms–is often the culprit behind vaginal dryness. Because estrogen helps to keep vaginal tissue thick, stretchy, and lubricated, a decrease in the production of this hormone causes these tissues to become thinner and less elastic. The vagina loses moisture, too, resulting in a dryer, less flexible environment;3 all of which can contribute to pain, irritation, burning and discomfort.
The reason for vaginal dryness isn’t always tied to estrogen loss, however. Some non-hormonal factors may trigger this symptom as well, including:
- Certain medications, such as medroxyprogesterone (used in some birth control) or leuprolide (taken to manage endometriosis or uterine fibroids)4. It’s important to note that any and all contraception that works to suppress ovulation could also be associated with vaginal dryness.
- Surgical removal of one or both ovaries (known as an oophorectomy), which is usually done in attempt to prevent or treat cancer5. It can also be done in cases of severe endometriosis, chronic pelvic pain, benign masses, etc.
- Stress, immune system disorders, or infections6
How Can I Prevent Vaginal Dryness?
Currently, there isn’t a way to prevent vaginal dryness from occurring during menopause, but there are steps you can take to prevent it from disrupting your daily quality of life. Dr. Levy-Gantt emphasizes the importance of caring for the vagina in the same manner that you care for the rest of your body. “The vagina should remain healthy whether or not women are sexually active,” she says. “If women do not use or do anything to maintain vaginal health as they age, the vaginal tissues will become drier and thinner, and, if in the future they decide they want to return to sexual activity, they may not be able to have comfortable, pain free sex.”
Some ways to help maintain optimal vaginal health, with the goal of minimizing discomfort and allowing you to continue your regular activities without pain, include:7
- Avoiding washing the inside of your vagina. The vagina cleans itself naturally, so douching is never necessary and may be harmful to the vagina’s delicate pH.
- Wipe from front to back after urinating, so harmful bacteria doesn’t spread to the vagina.
- Allow plenty of time for foreplay during sexual activity, so that the vagina has time to lubricate itself well before penetration.
Are There Ways to Treat Vaginal Dryness?
Vaginal tissue that has become thinner and easily irritated due to decreased estrogen levels should be treated carefully to minimize any pain. Dr. Levy-Gantt recommends using products containing hyaluronic acid to soothe irritated vaginal tissue, especially for women who are unable to use estrogen-based solutions for health reasons or because of personal preference. But there are alternatives to consider. Other products that are readily available and easy to use for managing vaginal dryness can include:8
- Moisturizers – available over the counter and in most drug stores may be applied every few days to increase moisture in the vagina, and to help keep tissue healthy.
- Lubricants – these are typically applied just before sexual activity to help minimize pain during insertion or intercourse.
- Estrogen rings, tablets, or creams – these low-dose, hormone-based, prescription options help to reinvigorate vaginal tissues, restoring moisture and pliability.
Are Estrogen-Based Solutions for Vaginal Dryness Safe?
“Products containing a low-dose estrogen can be completely safe for most women,” explains Dr. Levy-Gantt. “My recommendations for [symptom] management always start with taking a history,” she notes. “If the woman is in menopause and not on any menopausal hormone therapy, and vaginal symptoms are her main complaint, I recommend vaginal estrogen, as long as there's no reason she cannot use it.” Some health conditions, however, such as certain types of cancers, may prevent women from using estrogen-based products.
As always, be sure to talk with your healthcare provider before considering any new medications or treatment options. They can help advise on what is best for you based off your medical history and personal preferences.
More Natural Solutions for Managing Vaginal Dryness in Menopause
Some women may prefer to avoid estrogen or other prescriptions altogether when addressing their vaginal dryness. While most natural remedies haven’t been scientifically proven to be effective when it comes to relieving vaginal dryness in menopause, some women may still favor an all-natural regimen. Some natural remedies include Kudzu root and soy (which are phytoestrogens, meaning they act somewhat like estrogen in the body).9
It’s a good idea to ask your healthcare provider if they feel a natural supplement is a good solution for your vaginal dryness symptoms before trying anything new. Dr. Levy-Gantt agrees: “Besides vaginal moisturizers, there are no evidence-based studies that say you should put anything in your vagina to make it healthier, except what is recommended by a knowledgeable menopause practitioner.”
When to Contact Your HCP About Vaginal Dryness
Any time you notice a change in your vaginal health, a chat with a medical professional is recommended. Consider contacting your healthcare provider if vaginal dryness or another change in your vaginal health:10
- Interferes with daily activities
- Affects your physical intimacy
- Is connected to notable vaginal bleeding
Although many women experience vaginal discomfort or pain during and after menopause, you shouldn’t have to ever “just deal with it.” Understanding your options to help ease vaginal dryness is the first step toward maintaining a healthy lifestyle–one that’s pain-free, and that allows you to continue to enjoy your daily activities.