Suffering from vaginal dryness is a common issue – one in three women will experience this throughout their lives. However, there is no need to suffer in silence as there are new solutions to solve vaginal dryness.Talking to your gynaecologist is the first step.
What are the symptoms of vaginal dryness?
If you start experiencing itching and burning, or a general irritation in the vaginal area, it’s likely you’re suffering from vaginal dryness. Perhaps sex feels uncomfortable, or even painful. As a result you find yourself losing your libido.
Other symptoms of vagina dryness
- There’s an alteration in the appearance of the vagina – it may appear paler
- You have to urinate more frequently
- You frequently get urinary infections such as cystitis
What causes vaginal dryness?
There are many reasons for experiencing vaginal dryness.
Stress and overzealous hygiene routines (for example, douching), can cause vaginal dryness as can certain illnesses, like diabetes or Sjögren’s syndrome. Medications can also cause issues. One of the side effects of radiotherapy and chemotherapy may be vaginal dryness.
However, the most common cause for vaginal dryness is the menopause.
Over half of post-menopausal women aged between 51 and 60 say that vagina dryness is a problem.
The menopause and vaginal dryness
The vagina is kept lubricated by glands at the top of the cervix. These ensure the vagina is supple and helps keep the vagina in good working order. The vagina is also kept at the right PH level to prevent infections.
The levels of moisture in the vagina are in part controlled by oestrogen and progesterone, which also are key for controlling the menstrual cycle and fertility.
The ovaries have two main reproductive functions – firstly egg production and secondly the production of hormones, oestrogen and progesterone.
During menopause, the number of ovarian follicles declines – so this means less oestrogen.
So, along with all of the other symptoms of the perimenopause and the menopause, vaginal dryness is an issue.
The technical name for vaginal dryness is vaginal atrophy, also known as vulvo-vaginal atrophy (VVA) or atrophic vaginitis.
Gynaecologists are increasingly also using the term Genitourinary Syndrome of Menopause (GSM). This is because the medical terminology vaginal atrophy does not completely convey all of the symptoms that are caused by the issue of vaginal dryness.
What is Genitourinary Syndrome of Menopause (GSM)?
This umbrella term for symptoms caused by vaginal dryness includes:
- Feelings of dryness in the vaginal area
- Lack of moisture during sexual relations
- Pain during sex
- A generalised sensation of burning and irritation
- An urge to urinate often
- Discomfort when urinating
- Frequent urinary tract infections
How can vaginal dryness be treated?
- A vaginal moisturiser can help
- A water-based lubricant when having sex
- HRT containing oestrogen
- Bioidentical hormones
- Topical oestrogen applied to the vagina
Can vaginal dryness be treated without oestrogen?
A laser has been developed which delivers fractional CO2 laser energy to the vaginal wall tissue, called the MonaLisa Touch Laser (MLT). There is good evidence to support its use for treating vaginal dryness and Genitourinary Syndrome of Menopause. Laser energy is applied to the vaginal via tiny dots. This has the effect of stimulating new collagen and restoring moisture to the membrane lining of the vaginal wall. The MLT tones and firms up the whole vaginal area, restoring its function, and ensuring suppleness. It can also help associated issues, such as well as urinary incontinence and vaginal laxity.
What about other treatment for vaginal dryness?
Vaginal moisturisers and lubricants
If sex has become painful, using lubricants when you make love as this whould ease problems.
If you’re going to use a vaginal moisturiser, you should talk to your doctor about which one is best to choose.
They can work over a few days, and are suitable for women who find vaginal dryness is an issue in everyday life – for example, bleeding during sex. Opt for water-based varieties, as oil or petroleum-based ones may cause infection.
Hormone replacement therapy (HRT)
Vaginal dryness can be helped by HRT (Hormone Replacement Therapy). HRT refers to the menopause treatment where women’s depleting hormones are replaced with synthetic equivalents, or bio-identical hormones. The term ‘bio-identical hormones’ refers to treatments which use identical molecules to ones our body produces. Women may be prescribed oestrogen only, such oestradiol, estrone and estriol. This is the type usually prescribed after a hysterectomy.
For women who have not had hysterectomies, they may be advised to take HRT which contains progestogen – a synthetic version of the hormone progesterone, (ie. norethisterone, dydrogesterone, medroxyprogesterone and levonorgestrel).
The progestogen as can prevent a condition called endometrial hyperplasia, which can lead to severe bleeding and cancer of the endometrium.
Many women are concerned that taking hormone replacement treatment is dangerous.
While it’s true that for certain women, HRT is not recommended and it’s not entirely without risks, it can be very helpful for menopausal symptoms, including vaginal dryness. It also has the added benefit of being protective against osteoporosis.
It’s available on prescription from your GP either as tablets, a skin patch, an implant under the skin, or a gel that’s applied to the skin.
HRT has a wider effect on the body than vaginal oestrogen, so may be best if you have other menopause symptoms, such as hot flushes. However, it also has more side effects.
Oestrogen creams and pessaries
Another way to introduce beneficial oestrogen into the vaginal area is through the use of oestrogen-based creams and pessaries, or vaginal rings.
Oestrogen treatment can be more effective than lubricants and moisturisers for menopausal women, and it generally causes few side effects.
They won’t work immediately, so you may need to use lubricants before the moisturising effect of oestroegen takes effect.
A consultation with a gynaecologist will give you a better idea at what will work better to help tackle vaginal dryness.