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Vaginal Dryness

November 17, 2010
The discomfort of vaginal dryness is experienced by almost every woman at some point in life. A dry vagina can feel itchy and burning, and can take the joy out of sex. In fact, vaginal dryness is a leading factor in female sexual dysfunction and painful intercourse.

Causes of Vaginal Dryness

A woman’s vagina naturally produces a clear, relatively odorless vaginal lubrication that assists in sexual penetration. How much lubricant is produced is influenced by a number of different factors and varies from woman to woman.

Factors that can influence vaginal dryness are:

  • Intercourse
  • Diaphragms
  • Antidepressants
  • Antihistamines/decongestants
  • Antibiotics
  • Chemotherapy
  • Radiation
  • Allergens such as dyes and fragrances in toilet paper and laundry detergent
  • Drying soaps
  • Douches
  • Tampons
  • Condoms

Low Estrogen and Vaginal Dryness

For most women, however, vaginal dryness is a direct result of lower estrogen levels that occur naturally during menopause, after the ovaries are removed and at other times in life. Estrogen causes the vagina to thicken. When estrogen decreases, the tissues of the vagina naturally thin, become less elastic, drier and more fragile.

Low estrogen levels may result from:

  • Menopause, perimenopause, postmenopause
  • Hysterectomy and related surgeries
  • Menstrual cycle changes
  • Pregnancy
  • Childbirth
  • Nursing
  • Some hormonal contraceptives
  • Endometriosis drugs
  • Infertility drugs
  • Stress, fatigue
  • Rigorous exercise

Over 80% of women suffer from vaginal dryness during perimenopause and beyond. For women who stop using HRT, vaginal dryness may be especially difficult.

Treatment Options

Whatever the cause or severity, you don’t need to live with symptoms such as vaginal itching, burning, irritation and pain. Whether constant or intercourse-related, these symptoms should be brought to the attention of your health care provider.


Women have several options for improving vaginal dryness and increasing the health of vaginal tissue without a prescription and without using hormones. Self-care basics include increasing your water intake to be sure your entire body is properly hydrated and avoiding certain products that may increase dryness or irritate sensitive vaginal tissue. These include soaps, detergents, bubble bath, douches, feminine sprays and other products with allergens, dyes and fragrances. Kegel exercises may help increase circulation to the pelvic area to keep tissue healthy and strong. Regular sexual activity can also help boost your body’s ability to produce vaginal moisture even after menopause.

Water-based Lubricants. If dryness is a problem during sexual intercourse, a water-based lubricant like Astroglide can increase vaginal comfort. Always use a personal lubricant that’s water-based and water-soluble, and slightly acidic (pH balanced) to match normal body fluids. This slight acidity helps inhibit the growth of harmful microorganisms, particularly yeast. Never use a petroleum-based product, petroleum jelly, mineral oil or edible oil in place of a good personal lubricant. These can adhere to vaginal walls, masking infections and providing a place for harmful organisms to multiply. They can also damage latex condoms and diaphragms, compromising their effectiveness for safe sex or birth control.

Moisturizing Creams. Although lubricants are fine for occasional dryness during intercourse, vaginal moisturizing creams are formulated to help improve the health of vaginal tissues and moisturize the vagina for a longer period of time. Some formulas include phytoestrogens that may help to naturally replenish declining estrogen levels. Generally, a small of amount of these creams is applied two or three times a week. Moisturizers may also help maintain the acidic environment in the vagina and decrease infections.

Prescription Therapy

Several prescription options are available for vaginal comfort and health. Conventional hormone replacement therapy (HRT) can be used to treat vaginal dryness and thinning associated with low estrogen as well as many other symptoms of menopause such as hot flashes and night sweats. However, your doctor may suggest localized estrogen therapy if your main concern is vaginal comfort and health. Localized therapy can:

  • Help maintain muscle tone of the vagina and urethra.
  • Reduce vaginal dryness, irritation, and pain.
  • Reduce urinary tract irritation and tendency toward infection.

Options for localized estrogen therapy delivered directly to the vaginal area include topical estrogen creams, vaginal estradiol rings and a vaginal tablet, all available from Madison Pharmacy Associates.


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