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Vaginal Dryness

Reviewed by Dr. Barb DePree, MD

Vaginal dryness is a common obstacle to comfortable sex for midlife women. Most often, it's one of the changes we all experience with menopause. Exploring this condition and choosing the vaginal dryness treatment that works for you can enhance your sex life and make it far more enjoyable.

Young women have plenty of estrogen and testosterone in their systems, keeping the vagina's tough, elastic lining strong and healthy. Vaginal lubrication? We never thought about it because we didn't have to. Lubrication happened at exactly the right moment. We didn't need to think about vaginal dryness treatment.

When What Used to Feel Good Doesn't
As estrogen levels decline, however, the vaginal lining changes, becoming less stretchy and more delicate (much like all the rest of our skin). Vaginal atrophy—the thinning and weakening, shortening and tightening of the vulvo-vaginal tissues—sets in. Blood vessels, muscles, and surrounding tissues all become less responsive over time. The first signal of this is often vaginal dryness; without treatment, it can get worse: vulvar pain, discharges, pain or stinging with intercourse, tearing or bleeding of increasingly delicate skin, and a variety of issues with urination. These add up to painful intercourse!

If You Don't Use It, You Lose It
As another complication, our falling testosterone levels (at 50, we have about half as much as we did at our peak at 25) can make sexual desire and drive half as strong as they used to be. Lower desire and painful penetration make us less likely to have sex, which then makes the vagina even less elastic and responsive. Yes, that's right: If you don't use it, you lose it.

Regular sex with penetration (with a partner or alone) helps to give the vagina what it needs to stay healthy and functional—blood flow to its tissues.

Meet Your New Best Friends
If you want sex to continue to be a part of your life, your new best friends for vaginal dryness treatment are:

  • Lubricants to use during sex and
  • Moisturizers to use regularly (every two or three days) between sexual encounters to keep your vagina moist.

If the dryness doesn't improve after using moisturizers and lubricants, or you are experiencing dryness all the time, talk to a gynecologist or menopause specialist you trust. Sometimes thinking it through and developing a plan with another person can really help.

Alternative Therapies
If you prefer to use alternative therapies, by all means, explore them. But please get advice from a qualified health care provider who is knowledgeable about sexual health. And definitely

  • Don't use packaged douches to treat vaginal dryness; they'll rob your vagina of healthy flora.
  • Don't use hand lotions, vinegar, or yogurt as moisture replacements. They're ineffective and may contain ingredients that will work against your healthy pH level.

While some alternative therapies may seem natural and easy, there's a lot of misinformation about them. Some can make the situation worse.

"What Are You Thinking?" When Dryness During Intercourse Persists
One extra note about your most critical sexual organ: your mind. When you're not actually in the mood for sex, or you are not aroused enough for sex, all the lubricants and moisturizers in the world won't make the experience pleasurable. Give yourself time, and ask for time from your partner to allow both your mind and your body to engage before sex.

Learn about the actions you could take, listed at right, to address this condition or see other conditions that could affect you.