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 Atrophy
  • Vaginal Atrophy
  • Vaginal Dryness
  • Vaginal Symptoms
  • Vulvovaginal Vaginal 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 14 May 2024, the author explains:

“Vaginal dryness can be a problem for many people after menopause. Vaginal dryness is the main symptom of what’s called genitourinary syndrome of menopause. The syndrome used to be called atrophic vaginitis or vaginal atrophy.

With this condition, vaginal tissues become thinner and irritated more easily. This is the result of falling levels of estrogen 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 (United States) Menopause Society’s 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 Menopause Society 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
  • 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) note:

“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

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”.7

Common or Not

How common is vulvovaginal atrophy (VVA)?

In Vaginal Atrophy: Epidemiology last updated 03 July 2023, according to the authors:

“Vaginal atrophy can be a common issue for all women. However, it shows much more prevalence among the postmenopausal population. Reports show that 15% of the female population experiences symptoms of vaginal atrophy before menopause, whereas 40% to 57% of postmenopausal women have symptoms. Menopause causes a dramatic 95% reduction in estrogen production”.8

Go Away or Not

Does vaginal dryness improve with time?

The Menopause Society note:

“Unlike hot flashes, which typically improve with time, GSM usually worsens over time without treatment”.9

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”.10

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”.11

In Vaginal Dryness: Treatment Options the Menopause Society 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…”.12

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”.13

Vaginal Estrogen

Can estrogen be placed directly into the vagina?

On page one in Deciding About Hormone Therapy Use, published July 2022, the Menopause Society 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)”.14

In The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Effectiveness: Local Treatment of Urogenital Atrophy published online 30 October 2023, the authors note:

“Urogenital symptoms due to estrogen insufficiency are under-recognized and under-treated. These symptoms can be effectively treated with an array of local therapies including intravaginal estrogen preparations or DHEA (prasterone) and intravaginal moisturizers. Concurrent progestogen therapy is not required. Many women require local therapy, in addition to systemic MHT, to relieve urogenital symptoms. It is important patients understand that treatment needs to be ongoing and is not simply a short course of therapy”.15

Compounded Vaginal Estrogen and Testosterone

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

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

“Notes: Compounded vaginal estrogen and testosterone are not FDA regulated or recommended for treatment of GSM in most cases”.16

Ospemifene for Urogenital Atrophy

Can Ospemifene be used for vulvo-vaginal atrophy symptoms in postmenopausal women?

In The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Effectiveness: MHT Formulations and Options published online 30 October 2023, the authors explain:

“Ospemifene is an oral selective estrogen receptor modulator indicated for vulvo-vaginal atrophy symptoms in postmenopausal women (60 mg/day). Ospemifene has an estrogen-like effect in the vagina (increases superficial cells and decreases parabasal cells, and lowers vaginal pH) and alleviates dyspareunia. The most common adverse effect is VMS, which occur in 10% of treated women”.17

Regular 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

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”.19

The MedlinePlus explain:

“Contact 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”.20

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”.21

Health Topics A-Z

Where may I find Health Topics A-Z 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. BMS TV: Bioidentical Hormones
  4. BMS TV: Urogenital Atrophy
  5. Bioidentical Hormones: Are They Safer?
  6. Caredownthere.com.au
  7. Consumer Video and Podcast Series: 2023 Consumer Videos and Podcasts – Premature and Early Menopause
  8. Consumer Video and Podcast Series: 2023 Consumer Videos and Podcasts – NAMS 2023 Nonhormone Therapies Position Statement for Bothersome Menopause Symptoms
  9. Consumer Video and Podcast Series: 2024 Consumer Videos and Podcasts – Preparing for Your Menopause Healthcare Visit
  10. DHEA
  11. Deciding About Hormone Therapy Use
  12. Douching
  13. Endometrial Safety of Low-Dose Vaginal Estrogens
  14. Endometrial Safety of Low-Dose Vaginal Estrogens [Video]
  15. Essential Information: See Your Doctor If
  16. Estrogen (Vaginal Route): Before Using
  17. Estrogen (Vaginal Route): Description and Brand Names
  18. Experiencing Vaginal Dryness? Here’s What You Need To Know
  19. FAQs: Vulvovaginal Health
  20. Find A Menopause Practitioner [United States and Other]
  21. Find An AMS Doctor [Australasian Menopause Society i.e. Australia and New Zealand]
  22. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  23. Genitourinary Syndrome of Menopause
  24. Genitourinary Syndrome of Menopause and the False Promise of Vaginal Laser Therapy
  25. Hormone Replacement Therapy (HRT): Vaginal Oestrogen
  26. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – About Vaginal Oestrogen
  27. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – Common Questions About Vaginal Oestrogen
  28. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – How and When To Use Vaginal Oestrogen
  29. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – Side Effects of Vaginal Estrogen
  30. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – Using Vaginal Oestrogen With Other Medicines and Herbal Supplements
  31. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – Who Can and Cannot Use Vaginal Oestrogen
  32. International Society for Sexual Medicine: Sexual Health Topics
  33. International Society for the Study of Vulvovaginal Diseases: Patient Handouts
  34. International Society for the Study of Women’s Sexual Health: Find A Provider
  35. 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
  36. Laser Treatment for Genitourinary Syndrome of Menopause (Scientific Impact Paper No. 72)
  37. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Sexual Wellbeing, Intimacy and Menopause [+ Video: Menopause Is the End of Your Sex Life]
  38. Lubricant Alternatives: What To Use and What To Avoid
  39. Managing Your Symptoms: Managing Bladder, Vaginal and Vulval Problems
  40. Mayo Clinic Minute: Reducing the Risks of Sexually Transmitted Infections [+ Video Courtesy: Mayo Clinic News Network]
  41. Mayo Clinic Q and A: Perimenopause Transitions and Concerns
  42. Menopause
  43. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
    Vaginal Dryness
  44. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  45. Menopause Preparedness Toolkit Video Series: Common Conditions Associated with Menopause and Midlife
  46. Menopause Preparedness Toolkit: A Woman’s Empowerment Guide
  47. Menopause Ruining Your Sex Life?
  48. Menopause Signs and Symptoms
  49. Menopause Symptoms: Mayo Clinic Expert Outlines Hormone and Nonhormonal Therapies
  50. Menopause Treatments: What Works, What Doesn’t
  51. Menopause, Perimenopause, Hormone Therapy and Other Treatments With Madelyn Butler, MD [Podcast]
  52. Menopause: Things You Can Do
  53. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  54. National Center for Complementary and Integrative Health: Herbs At A Glance
  55. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  56. Navigating Menopause Together: How Partners Can Help
  57. Navigating Menopause: Expert Insights and Solutions | Dr Susan Davis | The Proof Podcast EP 245
  58. Need Reliable and Accurate Information About the Menopause and HRT? Watch This!
  59. Perimenopause
  60. Perimenopause
  61. Perimenopause and Menopause Checklist: Translated Checklists
  62. Perimenopause and Menopause Symptom Checklist
  63. Prosayla Supported By ISSWSH [International Society for the Study of Women’s Sexual Health]
  64. Questions To Ask Your GP About Menopause
  65. Shedding Light on the Menopause Experience and Demystifying Treatment
  66. Sheplusfoundation.com [She+ Foundation [formerly The Patty Brisben Foundation of Women’s Sexual Health]]
  67. Supporting A Loved One Through Menopause
  68. The 2023 Practitioner’s Toolkit for Managing Menopause
  69. The Truth About Menopause Supplements | Dr Sarah Berry
  70. Tips To Help Manage Menopause Symptoms
  71. Urogenital Problems
  72. Using Natural Therapies In the Menopause Transition – Webinar
  73. Vaginal Atrophy
  74. Vaginal CO2 Laser Therapy versus Sham for Genitourinary Syndrome of Menopause Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
  75. Vaginal Dryness
  76. Vaginal Dryness
  77. Vaginal Dryness
  78. Vaginal Dryness
  79. Vaginal Dryness
  80. Vaginal Dryness
  81. Vaginal Dryness After Menopause: Since going through menopause, I often have vaginal dryness. The dryness makes having sex painful. Is there anything I can do about it?
  82. Vaginal Dryness Alternative Treatments
  83. Vaginal Dryness: What To Do About It
  84. Vaginal Laser Therapy for GSM/VVA: Where We Stand Now – A Review By the EUGA Working Group on Laser
  85. Vaginal Oestrogen Is A Treatment on the Rise, But Is It Safe?
  86. Vaginal and Vulval Pain: Know the Different Causes and When To Seek Help
  87. Videos & Podcasts: Videos – Interviews: Vulvar Diseases, Overview for Aging Women
  88. Vulval Irritation
  89. Vulva and Vagina
  90. Vulval and Vaginal Conditions
  91. Vulvovaginal Atrophy
  92. Webinars: Previous – Pay Attention on Your Way In! The Vulva Is An Important Organ Too
  93. What Is Vaginal Steaming and Is It Safe?
  94. What Types of Vaginal Oestrogens Are There?
  95. Which Vaginal Moisturiser Should You Use?[Video]
  96. Wild Yam
  97. World Menopause Day [18 October 2024]: Leaflet for Women [Multiply Languages]
  98. World Menopause Day [18 October 2024]: Poster for Women
    Vaginal Dryness

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: 09 September 2024
  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: 09 September 2024
  3. Laughlin-Tommaso, S. K. Vaginal Dryness After Menopause: How To Treat It? 14 May 2024. https://www.mayoclinic.org/vaginal-dryness-after-menopause/expert-answers/faq-20115086 Accessed: 09 September 2024
  4. Vaginal Dryness: Treatment Options. 2022: 1-2. Menopause Society https://menopause.org/wp-content/uploads/for-women/mn-vaginal-dryness_4e454569-8d3c-4346-a00b-515f46b378c9.pdf Accessed: 09 September 2024
  5. Vaginal Dryness: Treatment Options. 2022: 1-2. Menopause Society https://menopause.org/wp-content/uploads/for-women/mn-vaginal-dryness_4e454569-8d3c-4346-a00b-515f46b378c9.pdf Accessed: 09 September 2024
  6. Looking After Yourself: Sex and Relationships – What Can Affect Your Sex Life? Dry Vagina and Pain During Sex. Last Updated: 12 August 2024 | 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: 09 September 2024
  7. Vaginal Dryness: Basics – Definition. 01 February 2023. Mayo Clinic https://www.mayoclinic.org/symptoms/vaginal-dryness/basics/definition/sym-20151520 Accessed: 09 September 2024
  8. Bleibel, B; Nguyen, H. Vaginal Atrophy: Epidemiology. Last Updated: 03 July 2023 https://www.ncbi.nlm.nih.gov/books/NBK559297/ Accessed: 09 September 2024
  9. Vaginal Dryness. 2022:1. Menopause Society https://menopause.org/wp-content/uploads/for-women/mn-vaginal-dryness_4e454569-8d3c-4346-a00b-515f46b378c9.pdf Accessed: 09 September 2024
  10. Vaginal Dryness: Treatment. Review Date: 12 July 2023. MedlinePlus https://www.nlm.nih.gov/medlineplus/ency/article/000892.htm Accessed: 09 September 2024
  11. Questions To Ask Your GP About Menopause:  How Can I Manage Vaginal Dryness? Last Updated: 26 July 2024 | Last Reviewed: 22 August 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/news/questions-to-ask-your-gp-about-menopause Accessed: 09 September 2024
  12. Vaginal Dryness: Treatment Options. 2022: 1-2. Menopause Society https://menopause.org/wp-content/uploads/for-women/mn-vaginal-dryness_4e454569-8d3c-4346-a00b-515f46b378c9.pdf Accessed: 09 September 2024
  13. 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: 09 September 2024
  14. Deciding About Hormone Therapy Use. 2022:1. Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 09 September 2024
  15. Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., and Islam, R. M. The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Effectiveness: Local Treatment of Urogenital Atrophy. First Published Online 30 October 2023 https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783 Accessed: 09 September 2024
  16. Vaginal Dryness: Notes. 2022: 2. Menopause Society https://menopause.org/wp-content/uploads/for-women/mn-vaginal-dryness_4e454569-8d3c-4346-a00b-515f46b378c9.pdf Accessed: 09 September 2024
  17. Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., and Islam, R. M. The 2023 Practitioner’s Toolkit for Managing Menopause: Management – MHT Formulations and Options. First Published Online 30 October 2023 https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783 Accessed: 09 September 2024
  18. Menopause Signs and Symptoms: Vaginal Dryness and Painful Sexual Intercourse. Endocrine Society. https://www.endocrine.org/menopausemap/signs-and-symptoms/index.html Accessed: 09 September 2024
  19. 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: 09 September 2024
  20. Vaginal Dryness: When To Contact A Medical Professional. Review Date: 12 July 2023. MedlinePlus https://www.nlm.nih.gov/medlineplus/ency/article/000892.htm Accessed: 09 September 2024
  21. Vaginal Dryness: Notes. 2022: 2. Menopause Society https://menopause.org/wp-content/uploads/for-women/mn-vaginal-dryness_4e454569-8d3c-4346-a00b-515f46b378c9.pdf Accessed: 09 September 2024
Topic Last Updated: 18 October 2024 – Topic Last Reviewed: 09 September 2024

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