Vaginal Dryness

Vaginal dryness occurs when you have low levels of the hormone estrogen. When it’s at normal levels, estrogen helps keep the vagina moist and lubricated. It also helps the vaginal walls stay thick and flexible (elastic). But when estrogen levels drop, the vaginal walls become dry, thin, and easily irritated.

There are many reasons why you may have low estrogen levels and vaginal dryness. These include:

• Menopause. Your estrogen levels drop once you stop having your menstrual period. This is one of the main causes of vaginal dryness. Symptoms often start in the time leading up to menopause (called perimenopause).
• Surgery to remove your ovaries (oophorectomy). Your ovaries make the hormones estrogen and progesterone. Removing an ovary reduces your hormone levels. Removing both ovaries can trigger menopause.
• Birth control pills or other hormonal birth control. Some birth control methods that have estrogen or progesterone can lead to vaginal dryness. Stopping the medicines often restores your estrogen levels.
• Certain cancer treatments. These include chemotherapy, hormone therapy, and radiation to the pelvic area.
• Giving birth. Estrogen levels often start to rise again a few months after delivery.
• Breastfeeding. It may take a few months after you stop breastfeeding for your estrogen levels to increase.
• Sjogren syndrome. This autoimmune disorder causes dryness all over your body.
• Certain medicines. Some medicines that dry mucous membranes can also affect vaginal tissue. These include some cold and allergy medicines and some antidepressants.

Vaginal dryness can cause symptoms such as:

• A burning feeling when you pee (urinate)
• Needing to pee often
• Vaginal itching and pain
• Pain when sitting or standing
• Pain during vaginal exams
• Pain when having sex
• Bleeding after sex
• Urinary tract infections
• Changes in any vaginal discharge (such as being watery or a different color, or having a bad smell)

Many of these symptoms may be caused by other health problems. Always see your healthcare provider for a diagnosis.

There are many treatment options for vaginal dryness. Talk with your healthcare provider about what treatment is best for you..

You can buy these products over-the-counter at food stores and pharmacies:

• Lubricants and moisturizers. These products help to restore some moisture to vaginal tissue. Be sure to only use products that are made for the vagina.
  • Vaginal lubricants. Use a water-based lubricant in and around your vagina before having sex. Apply it to your partner too. This can help make intercourse less painful. Don’t use lubricants made with glycerin or petroleum jelly. Glycerin can irritate your vagina even more. Petroleum jelly can damage condoms or diaphragms.
  • Vaginal moisturizers. Use these inside your vagina about 3 times a week. They help keep your vaginal tissue moist.

These treatments are available by prescription. They may be an option if moisturizers and lubricants haven’t eased your symptoms:

• Low-dose vaginal estrogen. Low doses of estrogen can be inserted into your vagina as a cream, a tablet, or by using a soft, plastic vaginal ring. The ring stays inside your vagina and releases estrogen. It's changed every few months.
• Prasterone (also called DHEA or dehydroepiandrosterone). This is a vaginal suppository that releases a medicine that acts like estrogen. It helps reduce dryness you may have during sex.
• Ospemifene. This prescription medicine is taken as a pill by mouth. It's a nonhormonal option that acts like estrogen to ease vaginal dryness.

Talk with your healthcare provider to see if it’s OK for you to take medicine that has estrogen or ingredients that are like estrogen. These may not be an option if you are at risk for breast cancer or have had breast cancer.

Talk with your healthcare provider if you have any of the symptoms of vaginal dryness described above. Your provider can help you find what may be causing the condition and advise a treatment for you.