Vaginal Dryness: Causes, Symptoms & Treatment

Vaginal dryness is an irritating and often painful condition that can happen to women of any age. Although most common during and after menopause due to decreased estrogen levels, vaginal dryness can also occur while breastfeeding, or when taking certain medications.

The good news is that effective treatments, both natural and traditional, are available to ease the symptoms of vaginal dryness. 

Read on for more details on the causes of a dry vagina, the accompanying symptoms, and what treatment options are available to improve it.  

Vaginal Dryness: What is It?

A healthy vagina is ordinarily lined by natural lubrication to keep the vaginal walls plump and pliable. Vaginal dryness with thinning of the tissue, which is medically referred to as vaginal atrophy, is typically the result of less natural lubrication in the vagina.

In addition to leaving the vaginal walls thin, dry, and lacking elasticity, vaginal dryness often results in painful sex, discomfort while urinating, and a general sensation of tenderness in the vagina. 

Approximately 17% of women aged 18-50 are known to experience vaginal dryness and after menopause over 50% of women will typically feel one or more of the symptoms associated with a dry vagina. 

Symptoms of Vaginal Dryness

The symptoms of vaginal dryness can adversely affect the quality of a woman’s life in several ways.  While discomfort and pain are the most common symptoms, additional side effects include the following: 

• Burning sensation when peeing
• Irritation and itching around the vulva
• Vulvar pain
• Pain during sex (dyspareunia) 
• No interest in sex 
• Bleeding after sex due to micro tears in the vaginal walls 
• Frequent urge to urinate
• Recurring urinary tract infections (UTIs)
• Pain while sitting

What Causes Vaginal Dryness?

Vaginal dryness is typically due to a lack of natural lubrication in the vagina and is generally linked to low estrogen levels, but not always. At any age, a lack of sexual arousal before intercourse can result in a sensation of vaginal discomfort or dryness during sex, for example. 

Using synthetic douches, fragranced menstrual products, or scented soap to clean the vagina can alter the vaginal microbiome. This can allow harmful bacteria to thrive and develop into an infection that can result in vaginal irritation or dryness. Another cause is an autoimmune disorder called Sjogren’s syndrome, which is known to dry out the entire body, including the vagina. 

Childbirth & Breastfeeding

Women of reproductive age can experience vaginal dryness for up to three months after giving birth, and longer when breastfeeding. This is due to the increased levels of a milk-producing hormone called prolactin, which blocks estrogen production. As soon as babies are weaned, prolactin levels drop and estrogen naturally increases again.  

Medication

Medication is often necessary to treat other conditions, but certain medications can have a drying effect on the female genitalia. Cold and flu medications contain antihistamines and decongestants to dry out the mucus membranes in the nasal passage, but can also dry out the mucus membranes in the vagina.

SSRIs (selective serotonin reuptake inhibitors) which are used to treat depression can also have an impact on sexual arousal and vaginal lubrication. 

Conditions like endometriosis and fibroids are often treated with birth control pills or hormone treatments to lower estrogen levels. While symptoms associated with these conditions are often improved with these types of medication, vaginal dryness is often a side effect of low estrogen. 

Menopause

As women near the end of the reproductive stage of life during the mid to late 40s, perimenopause is initiated and the body naturally begins to lower its production of estrogen. Because estrogen encourages the production of vaginal lubrication, the natural moisturization of the vagina incrementally decreases along with estrogen levels. After menopause, more than half of women are known to experience vaginal dryness, genital inflammation and irritation.  

Cancer Treatment 

Chemotherapy and radiation treatment for cancer can minimize blood flow to the vaginal tissues, causing irritation and swelling in the genitals and a thinning of the vaginal walls. The ovaries can also get damaged during pelvic radiation treatment, which ceases the production of estrogen and causes early menopause symptoms like vaginal dryness. 

Hysterectomy

A hysterectomy involves the removal of the uterus and sometimes the ovaries and fallopian tubes. When the ovaries are removed during a hysterectomy, women typically experience menopause symptoms like hot flashes, mood swings, and vaginal dryness due to the immediate halt of estrogen production.  

Effective Treatments for Vaginal Dryness

To effectively treat vaginal dryness, it helps to first identify the cause. This can be determined by scheduling a consultation with your healthcare professional, which will typically involve some questions as to your symptoms, a gentle pelvic exam, and blood tests to investigate possible underlying conditions, infections, or hormone imbalances. 

Medication

If an underlying condition or vaginal infection is found to be the source of your vaginal dryness, medical treatment will normally be prescribed to alleviate the symptoms.  

Hormone Therapy

When a lack of estrogen is determined as the cause of vaginal dryness, hormone therapy is usually prescribed as treatment. This can be in the form of localized estrogen gels, creams, patches, or rings. However, not all women can use estrogen due to the increased risks of breast cancer and uterine cancer, so it’s best to speak honestly with your healthcare provider about your family history. 

In these cases, a natural alternative like Chasteberry (Vitex), can be just as effective in treating vaginal dryness and other symptoms associated with low estrogen levels without any of the risks.  

Vaginal Moisturizer & Personal Lubricant

In conjunction with medication or hormone therapy, vaginal moisturizers & personal lubricants are game-changers for relieving vaginal dryness. Applying a vaginal moisturizer daily and using personal lubricant for foreplay and intercourse can help keep the vagina moist and comfortable during the day and while having sex. 

That said, using a vaginal moisturizer made with synthetic ingredients could further irritate the sensitive vaginal skin, so look for an organically-made vaginal moisturizer for best results both inside the vagina and on the outer lips. A water-based lubricant is also safer and less irritating than oil or silicone-based lubricants. 

Vaginal Dilator Therapy

Regardless of your age or the cause of your vaginal dryness, one of the best treatments to encourage the production of natural lubrication and restore vitality to the vaginal walls is vaginal dilator therapy. The most effective vaginal dilators come in sets of graduating sizes with the smallest similar to the width and length of a tampon and the largest resembling an erect penis. 

Gently inserting the smallest dilator in a set with a generous amount of lubricant will help to improve blood flow to the vaginal tissues and encourage the vaginal muscles to slowly relax and stretch. As patients progress through the set of dilators over the coming weeks or months, natural lubrication will improve while the vaginal walls moisten and become more pliable. 

Women experiencing vaginal dryness while healing from cancer treatments or a hysterectomy would normally be prescribed a combination of all of the above to ensure a steady recovery. 

Conclusion

Vaginal dryness is a common condition during menopause but also experienced by women of any age due to low estrogen levels, vaginal infections, certain medications, or cancer treatments.

If you notice symptoms of vaginal dryness like discomfort while sitting, genital itching, pain during sex, or a burning sensation while urinating, schedule a consultation with your healthcare provider. Vaginal dryness can be successfully treated once the underlying cause is identified.  

References 

The American College of Gynecologists and Obstetricians - Experiencing Vaginal Dryness? Here's What You Need to Know - https://www.acog.org/womens-health/experts-and-stories/the-latest/experiencing-vaginal-dryness-heres-what-you-need-to-know

Women’s Health Concern. Vaginal Dryness - https://www.womens-health-concern.org/help-and-advice/factsheets/vaginal-dryness/

La Leche League International – Breastfeeding and Sex - https://llli.org/breastfeeding-info/breastfeeding-and-sex/

Health - 5 Medications That Can Lead to Vaginal Dryness - https://www.health.com/condition/cold/cold-medicine-cause-vaginal-dryness

The North American Menopause Society. Changes in the Vagina and Vulva - https://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-the-vagina-and-vulva

American Cancer Society - How Radiation Therapy Can Affect the Sex Life of Females with Cancer - https://www.cancer.org/cancer/managing-cancer/side-effects/fertility-and-sexual-side-effects/sexuality-for-women-with-cancer/pelvic-radiation.html

National Library of Medicine - The Effect of Hysterectomy on Women’s Sexual Function: a Narrative Review - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720466/#:~:text=In%20some%20studies%2C%20vaginal%20dryness,dryness%20and%20abnormal%20vaginal%20contractions