Vaginal dryness is a common problem for women during and after menopause, although inadequate vaginal lubrication can occur at any age. Vaginal dryness is a hallmark sign of vaginal atrophy (atrophic vaginitis) — thinning and inflammation of the vaginal walls due to a decline in estrogen.
A thin layer of moisture coats your vaginal walls. When you're sexually aroused, more blood flows to your pelvic organs, creating more lubricating vaginal fluid. But hormonal changes associated with your menstrual cycle, aging, menopause, childbirth and breast-feeding may affect the amount and consistency of this moisture.
Vaginal dryness may be accompanied by signs and symptoms such as:
- Itching or stinging around the vaginal opening and the lower part of the vagina
- Burning
- Soreness
- Pain or light bleeding with intercourse
- Urinary frequency or urgency
- Recurrent urinary tract infections
Vaginal dryness affects many women. 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.
Causes Of Vaginal Dryness
Conditions that contribute to vaginal dryness include the following:
1. Decreased estrogen levels:
Reduced estrogen levels are the main cause of vaginal dryness. Estrogen, a female hormone, helps keep vaginal tissue healthy by maintaining normal vaginal lubrication, tissue elasticity and acidity.
These factors create a natural defense against vaginal and urinary tract infections. But when your estrogen levels decrease, so does this natural defense, leading to a thinner, less elastic and more fragile vaginal lining and an increased risk of urinary tract infection.
Estrogen levels can fall for a number of reasons:
- Menopause or the transition time before menopause (perimenopause)
- Childbirth
- Breast-feeding
- Effects on your ovaries from cancer therapy, including radiation therapy, hormone therapy and chemotherapy
- Surgical removal of your ovaries
- Immune disorders
- Cigarette smoking
Medications:
Some allergy and cold medications contain decongestants that can decrease the moisture in many parts of your body, including your vagina. Anti-estrogen medications, such as those used to treat breast cancer, also can result in vaginal dryness.
2. Sjogren's syndrome
In an autoimmune disease called Sjogren's (SHOW-grins) syndrome, your immune system attacks healthy tissue. In addition to causing dry eyes and dry mouth, Sjogren's syndrome can also cause vaginal dryness.
3. Douching
The process of cleansing your vagina with a liquid preparation (douching) disrupts the normal chemical balance in your vagina and can cause inflammation (vaginitis). This may cause your vagina to feel dry or irritated.
Diagnosis Of Vaginal Dryness
Diagnosis of vaginal dryness may involve:
- Pelvic exam: Your doctor visually inspects your external genitalia, vagina and cervix and inserts gloved fingers into your vagina and rectum to feel (palpate) your pelvic organs for signs of disease.
- Pap test: Your doctor collects a sample of cervical cells for microscopic examination. He or she may also take a sample of vaginal secretions to check for signs of vaginal inflammation (vaginitis) or to confirm vaginal changes related to estrogen deficiency.
- Urine test: If you have associated urinary symptoms, you'll provide a urine sample to be analyzed for urinary conditions.
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