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. In Vaginal Dryness: Overview – What Is Vaginal Dryness? the (United States) Cleveland Clinic’s definition is:

“Vaginal dryness is a painful symptom that affects a person’s quality of life. It can cause pain during sitting, exercising, peeing and sexual intercourse. Normally, your vaginal lining is lubricated with fluid that helps keep it thick and elastic. Vaginal dryness happens when the tissues in your vagina are dry, thin and not well-moisturized. This leads to discomfort, especially during sex”.2

Vaginal Dryness and Menopause

What is the association between vaginal dryness and menopause?

In Vaginal Dryness After Menopause: How To Treat It?, published 07 December 2023, the author explains:

“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 genitourinary syndrome of menopause (GSM)?

DotS the definition of GSM may vary. On page one in Vaginal Dryness, published December 2022, the North American Menopause Society’s (NAMS) definition is:

“The genitourinary syndrome of menopause (GSM) includes bothersome vaginal, vulvar (lips of the vagina), and urinary symptoms that can affect quality of life, sexual satisfaction, and even your relationship with your partner”.4

On page one in Vaginal Dryness the NAMS explain:

Menopause and aging can affect the genitourinary system in these ways:

  • “Loss of estrogen at menopause may cause the vaginal tissues to become thin and dry, with decreased elasticity and lubrication, often resulting in pain with sexual activity, routine pelvic examinations, and even discomfort wiping after urination or wearing certain clothing.
  • Symptoms such as burning, itching, or irritation of the vulva; lack of lubrication and vaginal dryness; and discomfort or pain with sexual activity are common.
  • Burning on urination, increased frequency or urgency of urination, and increased risk for urinary tract infections also can occur.
  • Symptoms may be more severe in women who undergo menopause as a result of the surgical removal of both ovaries (surgical menopause) or because of chemotherapy for cancer treatment and in those who receive aromatase inhibitors for prevention or treatment of breast cancers”.5

Cause

What may cause vaginal dryness?

In Looking After Yourself: Sex and Relationships – What Can Affect Your Sex Life? Dry Vagina and Pain During Sex the (Australian) Jean Hailes for Women’s Health (JH) explain:

“The loss of oestrogen at menopause causes changes in the tissues of your vagina and vulva. This means your vagina becomes drier and less elastic, which can lead to vaginal irritation, vaginal atrophy and pain during sex”.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

Common or Not

How common is vulvovaginalatrophy (VVA)?

On page one in Could Altering Vaginal Microbiome Treat Vaginal Dryness and Painful Sex During Menopause? dated 25 January 2023, according to the NAMS:

“It is estimated that VVA occurs in approximately 50% of menopausal women”.9

Go Away or Not

Does vaginal dryness improve with time?

The NAMS note:

“Unlike hot flashes, which typically improve with time, GSM usually worsens over time without treatment”.10

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”.11

In Questions To Ask Your GP About Menopause: How Can I Manage Vaginal Dryness? Dr Elizabeth Farrell, gynaecologist and Medical Director of the JH explains:

“Many women are too embarrassed to ask this question, but if you’re suffering, try to seek help because there are treatments. Lubricants, vaginal moisturiser and vaginal oestrogens can help, as can regular intercourse”.12

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 Hormone Therapy…
    • Low-dose local estrogen…
    • FDA-approved low-dose vaginal estrogen products…
    • Dehydroepiandrosterone (DHEA; Prasterone)
    • Low-dose vaginal estrogen or DHEA and a history breast or uterine cancer…
  • Systemic Estrogen Therapy
  • Other Therapies…
    • Ospemifene
    • Vaginal Laser Therapy…”.13

Vaginal Lubricants and Vaginal Moisturizers

What are some examples of vaginal lubricants and vaginal moisturizers?

 In Vaginal Dryness: Care and Treatment – How Is Vaginal Dryness Treated? Lubricants and Moisturizers for Vaginal dryness the Cleveland Clinic explain:

“Lubricants and moisturizers are available without a prescription and can be purchased at drug or grocery stores. They work by replenishing your vaginal tissue and making it wet, which can help with pain during sex. You shouldn’t use moisturizers (such as for your face or body) that aren’t meant for your vagina.

  • Vaginal moisturizers: Apply vaginal moisturizers to the inside of your vagina every few days to keep your vaginal lining healthy. Some examples include Replens™, Luvena® and KY® Liquibeads.
  • Vaginal lubricants: Apply lubricants just before sexual intercourse to ease discomfort caused by sex. Astroglide® and KY® Jelly are examples of water-based vaginal lubricants. There are also silicone-based and oil-based lubricants”.14

Vaginal Estrogen

Can estrogen be placed directly into the vagina?

On page one in Deciding About Hormone Therapy Use, published July 2022, the NAMS elaborate on:

Vaginal Dryness“ If you are bothered only by vaginal dryness, you can use very low doses of estrogen placed directly into 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)”.15

On page three in the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause, first published online 10 June 2022, one of the recommendations is:

  • “Low-dose and ultra-low dose vaginal oestrogen preparations can be taken by perimenopausal and menopausal women experiencing genitourinary symptoms and continued for as long as required. All vaginal oestrogen preparations have been shown to be effective in this context and there is no requirement to combine vaginal oestrogens with systemic progestogen treatment for endometrial protection, as low-dose and ultra-low dose vaginal oestrogen preparations do not result in significant systemic absorption or endometrial hyperplasia”.16

Compounded Vaginal Estrogen and Testosterone

Are compounded vaginal estrogen and testosterone recommended for treatment of GSM?

On page two in Vaginal Dryness the NAMS’s notes include:

“Notes:
Compounded vaginal estrogen and testosterone are not FDA regulated or recommended for treatment of GSM in most cases”.17

Sexual Activity

Can regular sexual activity help?

In Menopause Signs and Symptoms: Vaginal Dryness and Painful Sexual Intercourse the (United States) Endocrine Society note:

“A drop in estrogen levels from menopause can cause the vagina to become dryer and more fragile. The vaginal dryness usually becomes worse with a lack of sexual activity. Sex stimulates blood flow in the vagina and aids in the production of vaginal fluids. So, sex actually keeps the vagina lubricated and healthy”.18

In Consumer Health: Treating Vaginal Dryness After Menopause the Mayo Clinic also note:

“Regular sexual activity or vaginal stimulation — with or without a partner — also helps maintain healthy vaginal tissues in women after menopause”.19

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”.20

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”.21

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”.22

On page two in Vaginal Dryness the NAMS note:

“Notes: Vaginal and vulvar symptoms not related to menopause include yeast infections, allergic reactions, and certain skin conditions, so consult your healthcare professional if symptoms do not improve with treatment”.23

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

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Links

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New or Updated

  1. Are Probiotics Good for Vaginal Health?
  2. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  3. Bioidentical Hormones Explained – A British Menopause Society Video
  4. Bioidentical Hormones: Are They Safer?
  5. CO2-Laser Therapy and Genitourinary Syndrome of Menopause: A Systematic Review and Meta-Analysis
  6. Caredownthere.com.au
  7. Complementary and Alternative Therapies Explained – A British Menopause Society Video
  8. Consumer Health: Treating Vaginal Dryness After Menopause
  9. Could Altering Vaginal Microbiome Treat Vaginal Dryness and Painful Sex During Menopause?
  10. Could Chamomile Vaginal Gel Improve the Sexual Function of Postmenopausal Women
  11. DHEA
  12. Deciding About Hormone Therapy Use
  13. Douching
  14. Dr Gail Busby – I Forgot To Ask the Doctor – Episode 9 The Menopause
  15. Early Menopause: Experiences and Perspectives of Women and Health Practitioners – Women’s Profiles
  16. Early Treatment of Vulvovaginal Atrophy May Prevent Distressing Symptoms
  17. Essential Information: See Your Doctor If
  18. Estrogen (Vaginal Route): Before Using
  19. Estrogen (Vaginal Route): Description and Brand Names
  20. Experiencing Vaginal Dryness? Here’s What You Need To Know
  21. FDA Approves Intrarosa for Postmenopausal Women Experiencing Pain During Sex [Food and Drug Administration, United States] [Generic Name: Prasterone]
  22. Find A Menopause Practitioner [United States and Other]
  23. Find An AMS Doctor [Australasian Menopause Society i.e. Australia and New Zealand]
  24. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  25. Hormone Replacement Therapy (HRT) Explained – A British Menopause Society Video
  26. Hormone Replacement Therapy (HRT): Types
  27. How Do I Deal With Vaginal Atrophy? — Ask Dr Jean
  28. I have heard that there are new non‐hormonal treatments for vaginal dryness during menopause. Are these treatments safe?
  29. International Society for Sexual Medicine: Sexual Health Topics
  30. International Society for the Study of Vulvovaginal Diseases: Patient Handouts
  31. International Society for the Study of Women’s Sexual Health: Find A Provider
  32. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause
  33. Laser Treatment for Genitourinary Syndrome of Menopause (Scientific Impact Paper No. 72)
  34. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Sexual Wellbeing and Intimacy During and After Menopause [+ Video: Menopause Is the End of Your Sex Life]
  35. Looking After Yourself
  36. Managing Your Symptoms: Managing bladder, vaginal and vulval problems
  37. Mayo Clinic Q and A: Managing Vaginal Dryness
  38. Mayo Clinic Q and A: Treatment for Vaginal Dryness for Menopausal Women
  39. Medical Advice: Treatment
  40. Menopause
  41. Menopause
  42. Menopause
  43. Menopause Explained – A British Menopause Society Video
  44. Menopause FAQs: Menopause Symptoms – Q. How can I counteract vaginal dryness during menopause?
  45. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
    Vaginal Dryness
  46. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  47. Menopause Preparedness Toolkit Video Series: Common Conditions Associated with Menopause and Midlife
  48. Menopause Preparedness Toolkit: A Woman’s Empowerment Guide
  49. Menopause Ruining Your Sex Life?
  50. Menopause Signs and Symptoms
  51. Menopause Symptoms: Mayo Clinic Expert Outlines Hormone and Nonhormonal Therapies
  52. Menopause Treatments: What Works, What Doesn’t
  53. Menopause – Information for Partners – Fact Sheet
  54. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  55. National Center for Complementary and Integrative Health: Menopausal Symptoms: In Depth
  56. Navigating Menopause Together: How Partners Can Help
  57. Patty Brisben Foundation for Women’s Sexual Health
  58. Vulvovaginal Pain LogPatty Brisben Foundation for Women’s Sexual Health: Guide To Sexual Health Providers
  59. Patty Brisben Foundation for Women’s Sexual Health: New! Vulvovaginal Pain Log
  60. Perimenopause
  61. Perimenopause
  62. Questions To Ask Your GP About Menopause
  63. Severe Postmenopausal Symptoms Decrease Quality of Life, But Can Be Treated
  64. Sex and Menopause: Treatment for Symptoms
  65. Sexual Difficulties In the Menopause
  66. Supporting A Loved One Through Menopause
  67. The 2020 Genitourinary Syndrome of Menopause Position Statement of The North American Menopause Society
  68. The Genitourinary Syndrome of Menopause: An Overview of the Recent Data
  69. The Health Issues We Don’t Like To Discuss
  70. Tips To Help Manage Menopause Symptoms
  71. Topical Estrogens and Non-Hormonal Preparations for Postmenopausal Vulvovaginal Atrophy: An EMAS Clinical Guide
  72. Urogenital Atrophy Explained – A British Menopause Society Video
  73. Urogenital Problems
  74. Using Natural Therapies In the Menopause Transition – Webinar
  75. Vaginal & Vulval Pain: Know the Different Causes and When To Seek Help
  76. Vaginal Atrophy
  77. Vaginal CO2 Laser Therapy versus Sham for Genitourinary Syndrome of Menopause Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
  78. Vaginal Dryness
  79. Vaginal Dryness
  80. Vaginal Dryness
  81. Vaginal Dryness
  82. Vaginal Dryness
  83. Vaginal Dryness
  84. 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?
  85. Vaginal Dryness Alternative Treatments
  86. Video Series-2022: Discussing Sexual Health Concerns With Your Health Care Professional
  87. Video Series-2022: Perimenopause, Signs, Symptoms, and Solutions
  88. Video Series-2022: Hormone Therapy: Understanding the Risks and Benefits
  89. Videos and Podcasts: Videos – Interviews: Vulvovaginal Atrophy
  90. Vulva & Vaginal Irritation
  91. Vulva and Vaginal Health: Getting the Right Advice
  92. Vulvovaginal Atrophy
  93. Vulvovaginal Health
  94. Webinars: Previous – Sexual Health Issues in Menopause
  95. Webinars: Previous: VVA – The Silent Epidemic [Vulvovaginal Atrophy]
  96. What Everyone Should Know About Menopause Symptoms
  97. What To Expect In Each Stage of Menopause
  98. What Is Vaginal Steaming and Is It Safe?
  99. Why Didn’t Anyone Tell Me This? Episode 3: Dr Annice Mukherjee: Your Essential Menopause Toolkit
  100. Wild Yam

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Vaginal Dryness: Basics – Definition. 01 February 2023. Mayo Clinic https://www.mayoclinic.org/symptoms/vaginal-dryness/basics/definition/sym-20151520 Accessed: 02 March 2023
  2. Vaginal Dryness: Overview – What Is Vaginal Dryness? Last Reviewed: 26 July 2022. Cleveland Clinic https://my.clevelandclinic.org/health/symptoms/21027-vaginal-dryness Accessed: 02 March 2023
  3. Laughlin-Tommaso, S. K. Vaginal Dryness After Menopause: How To Treat It? 07 December 2022. https://www.mayoclinic.org/vaginal-dryness-after-menopause/expert-answers/faq-20115086 Accessed: 02 March 2023
  4. Vaginal Dryness: Treatment Options. 2022: 1-2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 02 March 2023
  5. Vaginal Dryness: Treatment Options. 2022: 1-2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 02 March 2023
  6. Looking After Yourself: Sex and Relationships – What Can Affect Your Sex Life? Dry Vagina and Pain During Sex. Last Updated: 02 March 2023 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/looking-after-yourself#sex-and-relationships Accessed: 02 March 2023
  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: 02 March 2023
  8. Vaginal Dryness: Basics – Definition. 01 February 2023. Mayo Clinic https://www.mayoclinic.org/symptoms/vaginal-dryness/basics/definition/sym-20151520 Accessed: 02 March 2023
  9. Could Altering Vaginal Microbiome Treat Vaginal Dryness and Painful Sex During Menopause? 25 January 2023:1. North American Menopause Society https://www.menopause.org/docs/default-source/press-release/ospemifene-impact-on-vaginal-mirobiome.pdf Accessed: 02 March 2023
  10. Vaginal Dryness. 2022: 1. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 02 March 2023
  11. Vaginal Dryness: Treatment. Review Date: 13 July 2021. MedlinePlus https://www.nlm.nih.gov/medlineplus/ency/article/000892.htm Accessed: 02 March 2023
  12. Questions To Ask Your GP About Menopause:  How Can I Manage Vaginal Dryness? September 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/news/questions-to-ask-your-gp-about-menopause Accessed: 02 March 2023
  13. Vaginal Dryness: Treatment Options. 2022: 1-2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 02 March 2023
  14. Vaginal Dryness: Care and Treatment – How Is Vaginal Dryness Treated? Lubricants and Moisturizers for Vaginal Dryness. Last Reviewed: 26 July 2022. Cleveland Clinic https://my.clevelandclinic.org/health/symptoms/21027-vaginal-dryness Accessed: 02 March 2023
  15. Deciding About Hormone Therapy Use. 2022:1. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 02 March 2023
  16. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022:3-4. https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 02 March 2023
  17. Vaginal Dryness: Notes. 2022: 2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 02 March 2023
  18. Menopause Signs and Symptoms: Vaginal Dryness and Painful Sexual Intercourse. Endocrine Society. https://www.endocrine.org/menopausemap/signs-and-symptoms/index.html Accessed: 02 March 2023
  19. Consumer Health: Treating Vaginal Dryness After Menopause. 04 May 2021. Mayo Clinic https://newsnetwork.mayoclinic.org/discussion/consumer-health-treating-vaginal-dryness-after-menopause/ Accessed: 02 March 2023
  20. Vaginal Dryness: Basics – When To See A Doctor. 01 February 2023. Mayo Clinic https://www.mayoclinic.org/symptoms/vaginal-dryness/basics/when-to-see-doctor/sym-20151520 Accessed: 02 March 2023
  21. 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: 02 March 2023
  22. Vaginal Dryness: When To Contact A Medical Professional. Review Date: 13 July 2021. MedlinePlus https://www.nlm.nih.gov/medlineplus/ency/article/000892.htm Accessed: 02 March 2023
  23. Vaginal Dryness: Notes. 2022: 2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 02 March 2023
Topic Last Updated: 02 March 2023 – Topic Last Reviewed: 02 March 2023

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