Vaginal Dryness

If sex results in more discomfort than pleasure, and if it causes pain, irritation, burning or dryness, you might be experiencing vaginal dryness.

Vaginal dryness refers to a persistent irritating, burning, or itching sensation in the vagina. It is due to inadequate vaginal moisture that makes it feel too dry or too tight. The condition is more noticeable during sexual intercourse as it results in pain and discomfort.

• Vaginal itching, burning sensation, and irritation
• Reduced levels of natural vaginal secretions
• Tightening of vaginal opening
• Narrowing of vagina
• Pain during sexual intercourse
• Hot flashes
• Night sweats
• Fatigue and mood changes
• Insomnia
• Urinary symptoms

Vaginal dryness, also called vaginal atrophy or atrophic vaginitis, is a low-estrogen disorder. Estrogen, a hormone produced by your ovaries, helps keep the vulva and vagina moist and pliant.

But after menopause, hysterectomy, or breast cancer treatment, the levels of estrogen tend to drop. As a result, your vaginal skin changes and may become uncomfortably dry.

Vaginal dryness may be triggered by:

• Childbirth and breastfeeding
• Treatments for cancer, including radiation and chemotherapy
• Menopause
• Surgical removal of ovaries for any reason
• Anti-estrogen drugs for endometriosis or breast cancer
• Antidepressants
• Antihistamines, like diphenhydramine
• Sjogren’s syndrome

This condition can adversely impact your sexual health and even your daily life. Without normal lubrication levels, sex may become painful.

In some cases, vaginal tearing and bleeding may occur. Furthermore, irritation and itching can be frequent, and you may have an increased risk of vaginal infections.

Your urologist or urogynecologist will diagnose vaginal dryness based on a combination of factors, including your medical history and a physical exam.

To establish the cause, your provider will ask you about your symptoms and any medications you are taking.

Your provider may further conduct a pelvic exam to check if your vaginal tissue is thin and dry due to declining estrogen levels. A blood test may also be needed to check your hormone levels and bring out other medical issues responsible for your condition.

Your provider may recommend that you use vaginal moisturizers. The moisturizer is applied every few days to moisturize and keep your vaginal tissues healthy. You may also be recommended the use of vaginal lubricants to relieve pain during intercourse.

Regular sexual activity or vaginal stimulation can also help you to maintain healthy vaginal tissues after menopause.

Alternatively, you may be prescribed a low-dose vaginal estrogen cream, ring or tablet. When you apply it, the estrogen-based product re-invigorates your vaginal tissues.

A selective estrogen receptor modulator (SERM) medication may also be given to relieve painful intercourse associated with vaginal atrophy.

It also may be recommended that you use a nightly vaginal suppository, like dehydro-epiandrosterone (DHEA), to ease painful intercourse once you reach menopause.