Vaginal Dryness

“Vaginal dryness may be a problem for women at any age, although it occurs more frequently in older women, particularly after menopause”.1

Umbrella
What may the Vaginal Dryness Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Atrophic Vaginitis
  • Genital Atrophy
  • Genitourinary Syndrome of Menopause
  • Urogenital Problems
  • Vaginal Atrophy
  • Vaginal Dryness
  • Vaginal Symptoms
  • Vulvovaginal Atrophy

Vaginal Dryness

What is vaginal dryness?

DotS the definition of vaginal dryness may vary. The (United States) MedlinePlus’ definition is:

“Vaginal dryness is present when the tissues of the vagina are not well-lubricated and healthy”.2

Vaginal Atrophy

What is vaginal atrophy?

DotS the definition of vaginal dryness may vary. In Vaginal Dryness After Menopause: How To Treat It? the author’s definition is:

“Vaginal dryness is a hallmark sign of the genitourinary syndrome of menopause, also known as atrophic vaginitis or vaginal atrophy. With this condition, vaginal tissues become thinner and more easily irritated — resulting from the natural decline in your body’s estrogen levels during menopause”.3

Genitourinary Syndrome of Menopause

What is the association between the genitourinary syndrome of menopause (GSM) and vaginal dryness?

In Menopause Frequently Asked Questions: Menopause Symptoms – Q. How Can I Counteract Vaginal Dryness During Menopause? the North American Menopause Society (NAMS) elaborate on:

“A. Vaginal dryness is extremely common during menopause. It’s just one of a collection of symptoms known as the genitourinary syndrome of menopause (GSM) that involves changes to the vulvovaginal area, as well as to the urethra and bladder. These changes can lead to vaginal dryness, pain with intercourse, urinary urgency, and sometimes more frequent bladder infections. These body changes and symptoms are commonly associated with decreased estrogen. However, decreased estrogen is not the only cause of vaginal dryness”.4

In Vulvovaginal Symptoms After Menopause the Australasian Menopause Society elaborate on:

  • “As women age they will experience changes to their vagina and urinary system largely due to decreasing levels of the hormone oestrogen
  • The changes, which may cause dryness, irritation, itching and pain with intercourse are known as the genito-urinary syndrome of menopause (GSM) and can affect up to 50% of postmenopausal women. GSM was previously known as atrophic vaginitis or vulvovaginal atrophy (VVA)
  • Unlike some menopausal symptoms, such as hot flushes, which may disappear as time passes; genito-urinary problems often persist and may progress with time. Genito-urinary symptoms are associated both with menopause and with ageing”.5

Cause

What may cause vaginal dryness?

The (Australian) Jean Hailes for Women’s Health (JH) explain:

“The loss of oestrogen at menopause causes changes in the tissues of the vulva, vagina and bladder”.6

Other Causes

Apart from decreased estrogen, what may be other causes of vaginal dryness?

The NAMS note:

“It is important to stop using soap and powder on the vulva, stop using fabric softeners and anti-cling products on your underwear, and avoid wearing panty liners and pads”.7

Menopause

Is there an association between menopause and vaginal dryness?

According to the (United States) Mayo Clinic:

“Vaginal dryness may be a problem for women at any age, although it occurs more frequently in older women, particularly after menopause”.8

Treatment

What are some treatments for vaginal dryness?

In Vaginal Dryness: Treatment the MedlinePlus elaborate on:

“There are many treatments for vaginal dryness. Before treating your symptoms on your own, a health care provider must find out the cause of the problem”.9

In Menopause Management: Managing Vaginal Problems – Dry Vagina Treatments the JH elaborate on:

  • “Lubricants or Oil…
  • Vaginal Moisturizers…
  • Black Cohosh…
  • Linseed (Flaxseed)…
  • Vaginal Oestrogen…
  • Menopausal Hormone Therapy (MHT)…
  • Vaginal Laser Therapy…”.10

In Vaginal Dryness: Treatment Options the NAMS elaborate on:

  • “Nonhormone Remedies
    • Vaginal Lubricants…
    • Vaginal Moisturizers…
    • Regular Sexual Stimulation…
    • Expanding Your Views of Sexual Pleasure…
    • Vaginal Dilators…
    • Pelvic Floor Exercises…
  • Vaginal Estrogen Therapy…
    • An effective and safe treatment…
    • Government-approved low-dose vaginal estrogen products…
    • Standard doses of estrogen therapy…
  • Other Prescription Therapies…
    • Ospemifene …
    • Dehydroepiandrosterone (DHEA)”.11

Vaginal Estrogen

Can estrogen be placed directly into the vagina?

On page one in Deciding About Hormone Therapy Use published in June 2017, the NAMS elaborate on:

“If you are bothered only by vaginal dryness, you can use very low doses of estrogen placed directly in to the vagina. These low doses generally do not raise blood estrogen levels above postmenopause levels and do not treat hot flashes. You do not need to take a progestogen when using only low doses of estrogen in the vagina. (The MenoNote “Vaginal Dryness” covers this topic in detail)”.12

Revised Global Consensus Statement

What is one of the points of consensus about menopausal hormone therapy (MHT) and vaginal dryness?

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefits/Risk Profile of MHT – endorsed by seven menopause-related organizations – published online 20 June 2016, is:

  • “MHT, including tibolone, is effective in the treatment of vulvovaginal atrophy (VVA), now also considered as a component of the genitourinary syndrome of menopause (GSM). Local low-dose estrogen therapy is preferred for women whose symptoms are limited to vaginal dryness or associated discomfort with intercourse or for the prevention of recurrent urinary tract infections”.13

NICE Guideline

What do the (British) National Institute for Health and Care Excellence (NICE) guidelines explain about HRT and vaginal dryness?

In Menopause: Diagnosis and Management – Information for the Public: Managing Your Symptoms – Vaginal Dryness the NICE explain:

“If you have vaginal dryness you should be offered vaginal oestrogen, which is put directly into the vagina as a pessary, cream or a vaginal ring. You can use vaginal oestrogen for as long as you need to, even if you are already using HRT. Moisturisers and lubricants can also help. If vaginal oestrogen doesn’t help to start with you may be offered a higher dose.

It’s rare for vaginal oestrogen to cause problems, but if you have any unexpected vaginal bleeding you should tell your GP. Your GP should explain that your symptoms may come back when you stop using it.

Vaginal oestrogen might be suitable for you if you can’t take HRT for medical reasons. Your GP should check this first with a healthcare professional specialising in menopause”.14

Who is a GP?

DotS and/or DotC (Depending on the Country) a GP may be a qualified and registered general practitioner, a medical practitioner, a medical doctor or a doctor.

Sexual Activity

Can regular sexual activity help?

The NAMS note:

“Regular sexual activity can help preserve vaginal function by increasing blood flow to the genital region and helping maintain the size of the vagina. Without sexual activity and estrogen, the vagina can become smaller as well as dryer”.15

Health Care Provider

What if I think I have vaginal dryness?

If you think you have vaginal dryness, it may be in your best interest to choose to talk to your health care provider about this. The Mayo Clinic explain:

“Vaginal dryness affects many women, although they frequently don’t bring up the topic with their doctors.

If vaginal dryness affects your lifestyle, in particular your sex life and relationship with your partner, consider making an appointment with your doctor. Living with uncomfortable vaginal dryness doesn’t have to be part of getting older”.16

The NAMS note:

“Persistent vaginal dryness and painful intercourse should be evaluated by your healthcare provider. If it is determined to be a symptom of menopause, vaginal dryness can be treated with low-dose vaginal estrogen, or the oral selective estrogen-receptor modulator (SERM) ospemifene can be used”.17

The MedlinePlus explain:

“Call your provider if you have vaginal dryness or soreness, burning, itching, or painful sexual intercourse that does not go away when you use a water-soluble lubricant”.18

On page two in Vaginal Dryness: Treatment Option the NAMS note:

“Note: Vaginal symptoms not related to menopause include yeast infections, allergic reactions, and certain skin conditions, so consult your health care provider if symptoms do not improve with treatment”.19

Health Topics A-Z

Where may I find Health Topics related to the Vaginal Dryness?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

Where may I find Links related to Vaginal Dryness?

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Links

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  1. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 6. Myth – Complementary Medicines and Therapies Are As Effective As MHT and Safer
  2. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 7. Myth – Compounded Bioidentical Hormone Therapy Is Safer Than Conventional MHT
  3. Bioidentical Hormones Explained – A British Menopause Society Video
  4. Bioidentical Hormones: Are They Safer?
  5. Vaginal Dryness Caredownthere.com.au
  6. Complementary Medicine Options for Menopausal Symptoms
  7. Complementary and Alternative Therapies Explained – A British Menopause Society Video
  8. DHEA
  9. Deciding About Hormone Therapy Use
  10. Douching
  11. Early Menopause: Experiences and Perspectives of Women and Health Practitioners – Women’s Profiles
  12. Early Treatment of Vulvovaginal Atrophy May Prevent Distressing Symptoms
  13. Essential Information: See Your Doctor If
  14. Estrogen (Vaginal Route): Before Using
  15. Estrogen (Vaginal Route): Description and Brand Names
  16. Everything You Wanted To Know About Painful Sex… But Were Too Embarrassed To Ask
  17. FDA Approves Intrarosa for Postmenopausal Women Experiencing Pain During Sex [Food and Drug Administration, United States] [Generic Name: Prasterone]
  18. Fact Sheets and Downloads: Additional Downloadable Resources – Vaginal Estrogen Therapy
  19. For Women Factsheets
  20. HRT and Alternatives
  21. Hormone Replacement Therapy (HRT) Explained – A British Menopause Society Video
  22. Hormone Replacement Therapy (HRT): Types
  23. I have heard that there are new non‐hormonal treatments for vaginal dryness during menopause. Are these treatments safe?
  24. Information About Menopause [Multiply Languages] [Videos]
  25. Intercourse Was Becoming Painful… – Ask Dr Jean
  26. International Society for the Study of Vulvovaginal Disease: Resource Library – Patients
  27. Libido: The Highs and Lows of Midlife
  28. Mayo Clinic Q and A: Managing the Symptoms of Vaginal Atrophy
  29. Medical Advice: Treatment
  30. Menopause
  31. Menopause
  32. Menopause
  33. Menopause Explained – A British Menopause Society Video
  34. Menopause FAQs: Hormone Therapy for Menopause Symptoms
  35. Menopause FAQs: Menopause Symptoms – Q. How can I counteract vaginal dryness during menopause?
  36. Menopause Management: Managing Vaginal Problems
  37. Menopause Symptoms and Relief
  38. Menopause What Are the Symptoms?
  39. Menopause and Women’s Health In Later Life
  40. Menopause – Non-Hormonal Treatment Options [Multiply Languages] [Video]
  41. Menopause – What Is Menopausal Hormone Therapy (HRT)? [Multiply Languages] [Video]
  42. Menopause – Will It Affect My Sex Life? [Multiply Languages] [Video]
  43. Menopause: Diagnosis & Treatment
  44. Menopause: Diagnosis and Management – Information for the Public: Managing Your Symptoms [NICE Guideline]
  45. Menopause: Diagnosis and Management – Information for the Public: Questions To Ask About Menopause [NICE Guideline]
  46. Menopause: Hormone Replacement Therapy (HRT) [Video Interview Stories]
  47. Menopause: Libido, Vaginal Dryness and Urinary Problems and the Menopause [Video Interview Stories]
  48. Menopause: Medicines To Help You
  49. Menopause: Menopause – Hormone Treatments
  50. Menopause: Non-HRT and Lifestyle Options [Video Interview Stories]
  51. Menopause: Relationships, Sex and Contraception and the Menopause [Video Interview Stories]
  52. Menopause: Symptoms & Causes
  53. Mona Lisa Touch – Ask Dr Jean
  54. NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use
  55. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  56. National Center for Complementary and Integrative Health: Menopausal Symptoms: In Depth
  57. New Study Reassures Women About the Safety of Vaginal Estrogen
  58. Pain During or After Sex
  59. Recent Review Confirms Safety of Low Dose Vaginal Estrogen: July 2019
  60. Severe Postmenopausal Symptoms Decrease Quality of Life, But Can Be Treated
  61. Sex & Relationships: 5 Things To Know About Sex In Later Life [Video]
  62. Sex and Menopause: Treatment for Symptoms
  63. Sexual Difficulties In The Menopause
  64. Sexual Health: Keeping Your Vagina Clean and Healthy
  65. Sexual Health: Sex After Hysterectomy
  66. Statement From FDA Commissioner Scott Gottlieb, M.D., on Efforts To Safeguard Women’s Health From Deceptive Health Claims and Significant Risks Related To Devices Marketed for Use In Medical Procedures for “Vaginal Rejuvenation” [Food and Drug Administration, United States]
  67. The Vaginal Laser Therapy versus Vaginal Estrogen Therapy: The VeLVET Trial [Video]
  68. The Vulva & Vagina – Fact Sheet
  69. The Vulva: Irritation, Diagnosis & Treatment – Booklet
  70. Urogenital Atrophy Explained – A British Menopause Society Video
  71. Urogenital Problems
  72. Vaginal & Vulval Pain: Know the Different Causes and When To Seek Help
  73. Vaginal Atrophy
  74. Vaginal Atrophy
  75. Vaginal Dryness
  76. Vaginal Dryness
  77. Vaginal Dryness
  78. Vaginal Dryness
  79. Vaginal Laser Therapy Vaginal Dryness After Menopause: How To Treat It? I’m postmenopausal and often have vaginal dryness, which makes intercourse painful. Is there anything I can do about it?
  80. Vaginal Dryness and the Menopause
  81. Vaginal Dryness: Alternative Treatments
  82. Vaginal Health After Breast Cancer: A Guide for Patients
  83. Vaginal Laser Therapy
  84. Vaginal Laser, Estrogen Treatments Similarly Improve Menopausal Symptoms
  85. Video Series-2018 – Moisturizers, Lubricants, and Prasterone
  86. Video Series-2019 – Talking To Your Clinician About Sexual Health Concerns
  87. Video Series-2019 – Treatment Options for Vaginal Dryness In Survivors of Breast Cancer and In Those With A High Risk of Breast Cancer
  88. Vulva & Vaginal Irritation
  89. Vulva and Vaginal Health: Getting the Right Advice
  90. Vulvovaginal Health
  91. Vulvovaginal Symptoms After Menopause
  92. What Is Menopausal Hormone Therapy (MHT) and Is It Safe?
  93. Wild Yam
  94. vaginal Dryness Will Menopause Affect My Sex Life? [+ Video]
  95. Women Can Breathe Sigh of Relief When Using Vaginal Estrogen To Treat Menopause Symptoms
  96. Women’s Wellness: How To Treat Vaginal Dryness After Menopause
  97. Women’s Wellness: Painful Sex After Menopause
  98. Women’s Wellness: Signs and Symptoms of Vaginal Health Problems
  99. World Menopause Day: World Menopause Day 2018 – Patient Information Leaflet: Sexual Wellbeing After Menopause [Multiply Languages]
  100. World Menopause Day: World Menopause Day 2019 – Patient Information Leaflet: Testosterone for Women At Midlife [Multiply Languages]

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Vaginal Dryness: Basics – Definition. 27 November 2018. Mayo Clinic https://www.mayoclinic.org/symptoms/vaginal-dryness/basics/definition/sym-20151520 Accessed: 21 September 2020
  2. Vaginal Dryness. Review Date: 30 June 2019. Page Last Updated: 16 September 2020. MedlinePlus https://www.nlm.nih.gov/medlineplus/ency/article/000892.htm Accessed: 21 September 2020
  3. Laughlin-Tommaso, S. K. Vaginal Dryness After Menopause: How To Treat It? 11 July 2020. https://www.mayoclinic.org/vaginal-dryness-after-menopause/expert-answers/faq-20115086 Accessed: 21 September 2020
  4. Menopause FAQs: Menopause Symptoms – Q. How Can I Counteract Vaginal Dryness During Menopause? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-menopause-symptoms Accessed: 21 September 2020
  5. Vulvovaginal Symptoms After Menopause. Content Created: September 2018. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/376-vulvovaginal-symptoms-after-menopause Accessed: 21 September 2020
  6. Menopause Management: Managing Vaginal Problems. Last Updated: 31 July 2020 | Last Reviewed: 17 December 2017. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 21 September 2020
  7. Menopause FAQs: Menopause Symptoms – Q. How can I counteract vaginal dryness during menopause? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-menopause-symptoms Accessed: 21 September 2020
  8. Vaginal Dryness: Basics – Definition. 27 November 2018. Mayo Clinic https://www.mayoclinic.org/symptoms/vaginal-dryness/basics/definition/sym-20151520 Accessed: 21 September 2020
  9. Vaginal Dryness: Treatment. Review Date: 30 June 2019. Page Last Updated: 16 September 2020. MedlinePlus https://www.nlm.nih.gov/medlineplus/ency/article/000892.htm Accessed: 21 September 2020
  10. Menopause Management: Managing Vaginal Problems – Dry Vaginal Treatment. Last Updated: 30 July 2020 | Last Reviewed: 17 December 2017. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 21 September 2020
  11. Vaginal Dryness: Treatment Options. 2018: 1-2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 21 September 2020
  12. Deciding About Hormone Therapy Use. 2017:1. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 21 September 2020
  13. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT. Climacteric, 2016;19:4:313 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 21 September 2020
  14. Menopause: Diagnosis and Management – Information for the Public: Managing Your Symptoms – Vaginal Dryness. Published Date: 12 November 2015. Last Updated: 05 December 2019. National Institute of Health Care and Excellence  https://www.nice.org.uk/guidance/ng23/ifp/chapter/Managing-your-symptoms Accessed: 21 September 2020
  15. Menopause FAQs: Menopause Symptoms – Q. How can I counteract vaginal dryness during menopause? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-menopause-symptoms Accessed: 21 September 2020
  16. Vaginal Dryness: Basics – When To See A Doctor. 27 November 2018. Mayo Clinic https://www.mayoclinic.org/symptoms/vaginal-dryness/basics/when-to-see-doctor/sym-20151520 Accessed: 21 September 2020
  17. Menopause FAQs: Menopause Symptoms – Q. How can I counteract vaginal dryness during menopause? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-menopause-symptoms Accessed: 21 September 2020
  18. Vaginal Dryness: When To Contact A Medical Professional. Review Date: 30 June 2019. Page Last Updated: 16 September 2020. MedlinePlus https://www.nlm.nih.gov/medlineplus/ency/article/000892.htm Accessed: 21 September 2020
  19. Vaginal Dryness: Note.  2018: 2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 21 September 2020

Topic Last Updated: 21 September 2020 – Topic Last Reviewed: 21 September 2020
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