Normally, the walls of the vagina stay lubricated with a thin layer of clear fluid. The hormone estrogen helps maintain that fluid and keeps the lining of your vagina healthy, thick, and elastic.
A drop in estrogen levels reduces the amount of moisture available. It can happen at any age from a number of causes.
It may seem like a minor irritation. But the lack of vaginal moisture can have a huge impact on your sex life. Fortunately, several treatments are available to relieve vaginal dryness.
Vaginal Dryness Causes
Vaginal dryness is common symptom of menopause -- and close to 1 in 3 women deal with it while going through "the change." It becomes even more common afterward. It also makes the vaginal tissue thinner and less elastic. This is called vaginal atrophy.
Estrogen levels can also drop because of:
- Childbirth and breastfeeding
- Radiation or chemotherapy treatment for cancer
- Surgical removal of the ovaries
- Anti-estrogen medications used to treat uterine fibroids or endometriosis
Other causes of vaginal dryness include:
- Sjögren's syndrome (an autoimmune disorder that attacks cells in the body that produce moisture)
- Allergy and cold medications
- Certain antidepressants
- Not enough foreplay before sex
No matter what the cause, vaginal dryness can be extremely uncomfortable. It can lead to itching, burning, and painful intercourse.
Vaginal Dryness Diagnosis
Any burning, itching, or discomfort in the area is worth a call to your doctor or gynecologist. They'll ask about your past health and find out how long you've had symptoms and what seems to make them worse or better.
Your doctor will do a pelvic exam, checking your vagina for any thinning or redness. The exam will help rule out other causes for your discomfort, including a vaginal or urinary tract infection. The doctor may also remove cells from your vaginal wall or cervix for a Pap test.
Medication for Vaginal Dryness
The most common treatment for vaginal dryness due to low estrogen levels is topical estrogen therapy. These replace some of the hormone your body is no longer making. That helps relieve vaginal symptoms, but it doesn't put as much estrogen in your bloodstream as the hormone therapy you take in pills.
Most women use one of three types of vaginal estrogen:
- Ring (Estring): You or your doctor inserts this soft, flexible ring into your vagina where it releases a steady stream of estrogen directly to the tissues. The ring is replaced every 3 months.
- Tablet (Imvexxy, Vagifem): You use a disposable applicator to put a tablet into your vagina once a day for the first two weeks of treatment. Then you do it twice a week until you no longer need it.
- Cream (Estrace, Estradiol, Premarin): You use an applicator to get the cream into your vagina. You'll typically apply the cream daily for 1 to 2 weeks, then cut back to one to three times a week as directed by your doctor.
Any estrogen product can have side effects, such as vaginal bleeding and breast pain. Topical estrogen may not be recommended when you:
- Have breast cancer, especially if you're taking an aromatase inhibitor
- Have a history of endometrial cancer
- Have vaginal bleeding but don't know why
- Are pregnant or breastfeeding
There isn't much research on the long-term use of topical estrogen, but there is an increased risk of developing endometrial cancer in women who still have their uterus.
You can buy a vaginal moisturizer like glycerin-min oil-polycarbophil (Replens) at your local drugstore or supermarket.
Hyaluronic acid-based vaginal suppositories such as Revaree can also safely keep the vagina lubricated. It can be bought online through major retailers or the manufacturer.
A drug taken orally once a day, ospemifeme (Osphena), makes vaginal tissue thicker and less fragile, resulting in less pain for women during sex. The FDA warns that Osphena can thicken the endometrium (the lining of the uterus) and raise the risk of stroke and blood clots.
Intrarosa is a steroid in the form of a vaginal suppository. It may cause vaginal discharge, and you may have an abnormal Pap test.
Take your time before having sex to make sure that you're fully relaxed and aroused. Apply a water-based lubricant (Astroglide, K-Y) to help enjoy intercourse more.
Avoid using douches, bubble baths, scented soaps, and lotions around the sensitive vaginal area. These products can worsen dryness.
Remedies and Treatments for Vaginal Dryness
Without treatment, vaginal dryness usually worsens over time. You can try these home remedies for vaginal dryness that may help relieve your symptoms and discomfort:
One of the best ways to reduce vaginal dryness is to use a vaginal moisturizer. These are special moisturizers that are designed specifically for this sensitive area of the body. Using a vaginal moisturizer every few days can help keep your vagina moist and relieve vaginal dryness symptoms.
You can apply the moisturizer a few times a week before bed. Apply it around the walls of the vagina to let it absorb. Don’t try to use a moisturizer or cream that is not specifically for the vagina. Similarly, you should avoid scented soaps, moisturizers, or other toiletries.
Before sexual activity, apply a water-based lubricant in your vagina and on your partner where there will be contact. Using a lubricant can help to relieve any pain or discomfort you might normally experience during sex, since you are giving this area moisture.
Be sure to choose a lubricant that doesn’t contain petroleum jelly or glycerin. Glycerin can cause your vagina to become even more irritated, and petroleum jelly can cause condoms to weaken or break during sex.
Regular sexual activity
Having sexual stimulation on a consistent basis can help improve your overall vaginal health. You can do this either alone or with a partner, or even using a device like a vibrator. Sexual stimulation helps increase blood flow and vaginal secretions and relieves vaginal dryness.
If you’re having sex with a partner, try engaging in foreplay before intercourse. This can make you feel more aroused so that sex is more enjoyable and comfortable. This can also help to promote blood flow and secretions to the vagina.
New approach to sex
While sexual activity is good for your vaginal health, rethink the way that you approach it. As mentioned, foreplay can be very helpful in getting ready for intercourse. Once you begin intercourse, take it slow. This helps to give the Bartholin’s glands time to produce more natural lubrication in your vagina.
You can also try other sexual activities that don’t involve intercourse but still let you be intimate with your partner. Activities like massaging, mutual masturbation, oral sex, or simply touching can be fulfilling. These activities are typically more comfortable if your vaginal dryness symptoms are especially bothersome.
Pelvic floor exercises
Pelvic floor exercises can help to strengthen weak vaginal muscles. With lower levels of estrogen, vaginal muscles weaken over time. Exercises like Kegels can help to relax tight muscles and strengthen weaker ones. These exercises also help to increase blood flow to the vagina.
If you’ve tried these remedies for vaginal dryness and are still experiencing discomfort, you should make an appointment with your doctor. Your doctor can talk to you about other treatment options that can help.