What Is Vaginal Dryness?

  • Aleena Rajan Master Of Public Health (MPH) -University of Wolverhampton
  • Olga Gabriel Master's degree, Forensic Science, Uppsala University, Sweden
  • Humna Maryam Ikram BS, Pharmacology, University of Dundee, Scotland, UK

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Introduction

Women, or assigned females at birth (AFAB) of all ages, can experience vaginal dryness, which is characterised by a lack of inborn lubrication in the vaginal canal. However, menopause is when it tends to become more pronounced. It happens frequently, yet its effects go far beyond simple discomfort. Intimate relationships can be ruined, self-esteem can be damaged, and general well-being might be hampered. Vaginal dryness has effects that go far beyond simple pain. Women who go through it could struggle with a variety of emotional and psychological problems.1 There may be feelings of humiliation, inadequacy, and a decreased sense of femininity, which can have detrimental effects on one's self-esteem and intimate relationships. The fact that vaginal dryness is a medical problem with workable treatments must be understood, though. This article aims to raise awareness of this frequently ignored issue while providing direction, empowerment, and hope to anyone suffering in silence. We will look at the causes, signs, and, most importantly, treatment options for vaginal dryness to restore the pleasure of intercourse and relieve suffering. In the sections thereafter, we will explore the causes of vaginal dryness in more depth, including hormonal changes and lifestyle choices. For AFAB to notice this condition early on and get the help they need, we will go over the warning signs and symptoms that may signal it. We'll also look at a variety of therapies that might ease discomfort and reestablish intimacy, ranging from lifestyle changes to medical procedures.2

Causes of vaginal dryness

The primary causes vaginal dryness are:

  1. Hormonal changes - Menopause is the most prominent cause of vaginal dryness. As oestrogen levels diminish throughout this period of life, the vaginal tissues become thinner, less elastic, and provide less natural lubrication.
  2. Medications - Some hormonal birth control methods, such as hormonal IUDs and oral contraceptives, might alter hormone levels and, in some cases, cause vaginal dryness. Also, as a side effect, antihistamines, and decongestants, which are available over the counter and on prescription, may cause vaginal dryness.
  3. Breastfeeding - Because breastfeeding inhibits oestrogen production, AFAB who are nursing may suffer hormonal changes that might cause vaginal dryness.
  4. Stress and anxiety - High levels of anxiety and stress can alter how the body regulates hormones, which may result in vaginal dryness.
  5. Chemotherapy and radiation therapy - Due to their impact on the hormonal environment and the tissues of the vagina, cancer treatments, including chemotherapy and pelvic radiation therapy, can result in vaginal dryness.
  6. Specific health issues - like Sjögren's Syndrome is an autoimmune disorder that can damage the glands responsible for creating moisture in the body, causing dryness in several places, including the vagina. Endometriosis can also result in vaginal dryness by causing scarring and inflammation in the pelvic region.
  7. Hygiene products and irritants - The use of abrasive soaps, douches, or fragrant, feminine hygiene products can upset the vagina's natural pH balance, causing dryness and irritation.
  8. Sensitivity and allergies - Sensitivities and allergic reactions to chemicals like spermicides or latex condoms can result in vaginal discomfort and dryness.
  9. Pregnancy and childbirth - These conditions might cause transient vaginal dryness due to hormonal changes and physical changes that occur throughout these processes.
  10. Ageing - Although menopause is an important cause, ageing itself can result in decreased vaginal lubrication and suppleness due to physiological changes in the body.
  11. Smoking and drinking - These lifestyle choices may have a detrimental impact on hormones and blood flow, which may be a factor in dry vaginal skin.
  12. Medical procedures - Vaginal dryness and diminished oestrogen production can result from surgeries that remove the ovaries or cause harm to the pelvic region.

Common symptoms of vaginal dryness

  1. Dryness and lack of lubrication - A dry, parched feeling in the vaginal area is the most overt and recognisable symptom. This is brought on by a lack of natural lubrication.
  2. Itching and irritation - Vaginal dryness frequently results in itching and irritation in the vulvar and vaginal regions, which is uncomfortable and results in a strong want to scratch.
  3. Burning sensation - Some AFAB may feel like they're being burned or stung, especially during or after using tampons or other forms of sexual activity.
  4. Pain or uncomfortable feeling during sexual interactions - Reduced vaginal lubrication can make sexual intercourse painful or uncomfortable, which may result in a reduction in sexual interest and activity.
  5. Vaginal Soreness - When vaginal tissues are dry, they are more prone to irritation and tiny wounds, which can cause soreness or discomfort.
  6. Increased urine Symptoms - Increased urine symptoms, such as frequent urination, urgency, or even a little rise in urinary tract infections (UTIs), can be linked to vaginal dryness.
  7. Light Bleeding - In extreme cases of vaginal dryness, light bleeding or spotting may occur during or after sexual contact due to stress to the vaginal tissues caused by friction.
  8. Exercise or Movement Uncomfortable - Activities like jogging or cycling can be uncomfortable since friction can make vaginal dryness worse.
  9. Vaginal Tissue Thinning - Over time, the vaginal tissues may become less elastic and pliable, which can aggravate symptoms and make them more susceptible to tears and accidents.

Health consequences

The following are some negative health effects of vaginal dryness: 

  • Dyspareunia - or painful intercourse, is a condition where there is insufficient lubrication in the vagina. Intimate relationships may also suffer as a result, as a woman's sexual satisfaction and desire are affected.
  • Increased risk of vaginal infections - Dry tissues in the vaginal area are more prone to tiny rips and injuries, which can leave spaces for dangerous germs. Due to this sensitivity, vaginal infections, including yeast and bacterial vaginosis, may become more common.
  • Urinary symptoms - Urinary symptoms, such as frequent urination, urgency, and even a modest rise in urinary tract infections (UTIs), can be linked to vaginal dryness. Additionally, these symptoms may be influenced by irritated vaginal tissues.3
  • Vaginal Atrophy (Atrophic Vaginitis) - Prolonged vaginal dryness, especially in postmenopausal AFAB, can cause vaginal atrophy, which is characterised by the thinning and inflammation of the vaginal tissues. Dryness and discomfort may worsen as a result.
  • Psychological and Emotional Effects - AFAB who experience vaginal dryness often experience severe emotional distress. A person's mental health and general quality of life may suffer from feelings of humiliation, inadequacy, and low self-esteem.4

Diagnosis and evaluation

Examining your medical history, talking about your symptoms, and having physical and hormonal examinations, all help in making the diagnosis of vaginal dryness. When providing care, healthcare professionals ask about symptoms, medications, menstrual history, and lifestyle choices. A pelvic exam looks for tissue abnormalities, dryness, or underlying problems. Hormone levels may be evaluated by blood testing, and acidity is measured with vaginal pH tests. Imaging tests or biopsies are rarely taken into consideration. Treatment options are explored after a diagnosis and may include hormonal medication, lubricants, moisturisers, lifestyle adjustments, or targeted medical procedures. For an accurate diagnosis and a customised treatment plan, open contact with your healthcare professional is crucial.5

Treatment methods

Common strategies include hormonal therapy, such as oestrogen replacement using topical creams, vaginal rings, or systemic pills. During sexual activity and everyday use, over-the-counter lubricants and moisturisers can offer rapid comfort. Modifying one's lifestyle to reduce stress, drinking more water, and staying away from triggers may ease symptoms. Platelet-rich plasma (PRP) injections or laser therapy may be options for AFAB who have severe symptoms. To decide the best course of treatment and ensure increased vaginal comfort, sexual satisfaction, and general quality of life, it is imperative to speak with a healthcare professional.6

Prevention

Maintaining vaginal health and addressing potential risk factors are necessary for preventing vaginal dryness. Vaginal lubrication can be supported by drinking enough water and eating a balanced diet that is rich in vital nutrients. Maintaining the pH balance naturally can be achieved by avoiding strong soaps, douches, and perfumed hygiene products. It is advised for AFAB to use drugs that cause dryness to speak with their doctor about possible substitutes. Dryness brought on by stress can be lessened with the aid of stress management strategies like yoga or meditation. The use of water-based lubricants or routine sexual activity can both improve vaginal health. To prevent vaginal dryness and provide long-term vaginal comfort, a healthy lifestyle and open contact with a healthcare practitioner are essential.7

Coping strategies

Applying water-based lubricants, drinking plenty of fluids, and practising good vaginal hygiene are ways to manage vaginal dryness. Sharing openly about this condition with a partner might lessen emotional strain. To effectively manage symptoms and enhance general well-being, speaking with a healthcare provider for treatment choices suited to the cause is crucial.1 

Summary

In a nutshell, a woman's physical comfort, emotional health, and intimate relationships can all be significantly impacted by vaginal dryness, a prevalent but sometimes ignored ailment. But there is still hope, and there are treatments that are efficient. AFAB who seek medical assistance might investigate a variety of options, such as hormone therapy and lifestyle modifications, to reduce symptoms and enhance their quality of life. For AFAB to regain their comfort, confidence, and the pleasures of intimacy, it is critical to end the taboo around this topic, have open discussions about it, and arm today's society with the knowledge necessary to manage and overcome vaginal dryness.

References

  1. Goncharenko V, Bubnov R, Polivka J, Zubor P, Biringer K, Bielik T, et al. Vaginal dryness: individualised patient profiles, risks and mitigating measures. EPMA Journal [Internet]. 2019 Mar [cited 2023 Sep 21];10(1):73–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459457/
  2. Waetjen LE, Crawford SL, Chang PY, Reed BD, Hess R, Avis NE, et al. Factors associated with developing vaginal dryness symptoms in women transitioning through menopause: a longitudinal study. Menopause [Internet]. 2018 Oct [cited 2023 Sep 21];25(10):1094–104. Available from: https://journals.lww.com/00042192-201810000-00007
  3. López DML. Management of genitourinary syndrome of menopause in breast cancer survivors: An update. World Journal of Clinical Oncology [Internet]. 2022 Feb 24 [cited 2024 Jan 8];13(2):71–100. Available from: https://www.wjgnet.com/2218-4333/full/v13/i2/71.htm
  4. Carranza-Lira S, Fragoso-Dı́az N, MacGregor-Gooch AL, Garduño-Hernández MP, Rı́os-Calderón K, Aparicio H. Vaginal dryness assessment in postmenopausal women using pH test strip. Maturitas [Internet]. 2003 May [cited 2023 Sep 21];45(1):55–8. Available from: https://pubmed.ncbi.nlm.nih.gov/12753944/
  5. McClelland SI, Holland KJ, Griggs JJ. Vaginal dryness and beyond the sexual health needs of women diagnosed with metastatic breast cancer. The Journal of Sex Research [Internet]. 2015 Jul 24 [cited 2023 Sep 21];52(6):604–16. Available from: https://www.researchgate.net/publication/264598736_Vaginal_Dryness_and_Beyond_The_Sexual_Health_Needs_of_Women_Diagnosed_With_Metastatic_Breast_Cancer
  6. Gelfand MM, Wendman E. Treating vaginal dryness in breast cancer patients: results of applying a polycarbophil moisturizing gel. Journal of Women’s Health [Internet]. 1994 Dec [cited 2023 Sep 21];3(6):427–34. Available from: https://www.liebertpub.com/doi/abs/10.1089/jwh.1994.3.42711. Stute P, May TW, Masur C, Schmidts-Winkler IM. Efficacy and safety of non-hormonal remedies for vaginal dryness: open, prospective, randomized trial. Climacteric [Internet]. 2015 Jul 4 [cited 2023 Sep 21];18(4):582–9. Available from: https://pubmed.ncbi.nlm.nih.gov/25845406/#:~:text=Conclusions%3A%20Subjective%20and%20objective%20VVA,to%20be%20superior%20to%20GEL.

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Aleena Rajan

Master Of Public Health (MPH) -University of Wolverhampton

Dr Aleena is an Ayurvedic Physician with extensive experience in hospital and clinical settings. She holds Indian licenses and board certification in Ayurvedic Medicine. She has worked as a consultant doctor for 3 years and also as Medical Officer for 2 years. She has dedicated her career to providing comprehensive medical care and improving the well-being of her patients. Currently, she is pursuing her postgraduation in public health.

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