Most women avoid talking about vaginal dryness (the medical term is “vaginal atrophy”) with their doctor, and sometimes even with their partner. It can be moderately uncomfortable to downright painful, and beyond frustrating - whether you have a healthy sex life or you’re simply trying to sit, stand, urinate or get an annual pap smear.
During menopause, estrogen levels drop and, without this hormonal stimulation, the tissues lining the vagina, vulva and bladder thin and dry out. Vaginal dryness may also be associated with various health conditions or be a side effect from surgery.
- Vaginal burning or discharge
- Light bleeding after intercourse
- Discomfort or pain with intercourse
- More time required to feel aroused
- Itching and burning
- Performance anxiety and emotional distress
Just as men feel pressure to “perform,” women can get anxious, especially when their body is not cooperating like it once did, making it even more difficult to enjoy intercourse. This may also lead to a loss in sex drive— something your doctor should know about, even if it’s awkward to discuss.
“As women age the vaginal tissue can become atrophic and dry, and they are more prone to having urinary tract infections,” says Dr. Brian Flynn, urologist.
Urinary issues are very common - burning or urgency with urination, urinary incontinence and an increased risk of developing urinary tract infections (UTIs). As women get older their hormones change, and the physiologic changes that occur with vaginal atrophy make them more vulnerable to bacterial infections. The risk of UTIs increases since atrophy not only thins the bladder lining but leads to a change in the acidic environment of the vagina, making it more susceptible to bacterial growth.
Commonly recommended treatments include:
- Vaginal moisturizersapplied regularly to restore and retain moisture
- Lubricants to reduce discomfort during intercourse
- Topical vaginal estrogen (i.e. rings, cream) at lower doses may provide direct relief and limits
- Urinary and vaginal probiotics
Lifestyle changes that help ensure a healthy and comfortable vagina
- Remember Kegel exercises? Doing these can help keep your pelvic floor muscles toned.
- Increasing sexual activity stimulates blood flow to the vagina, which keeps vaginal tissue healthy
- Forgoing use of douches or fragrant soaps that may contain chemicals that irritate or dry out the vagina.
- If you smoke, stop. Smoking reduces blood circulation, lessening flow to your vaginal area, which may inhibit sexual arousal.
- Limiting alcohol intake. Alcohol is a diuretic, reducing the amount of body fluids available for vaginal lubrication, and can impair sexual function.
Women’s Health: ‘A’ for Atrophy” by Laura Corio, MD:
Mayo Clinic - https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy