Vaginal Dryness

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Vaginal Dryness In Menopause

Vaginal dryness is a common symptom of menopause linked to a decrease in estrogen production. Normally, the vagina is lined with a moist layer, produced by vaginal cells, which facilitates sperm mobility and reduces friction during sex. As estrogen levels drop, this moisture diminishes, leading to dryness. Symptoms often include irritation, itching, a decrease in sexual desire, bleeding after intercourse, and frequent urinary tract infections. This condition can lead to discomfort, make sexual activity painful, and adversely impact one’s quality of life.

Why Does Vaginal Dryness Happen in Menopause?

Vaginal dryness occurs during and after menopause due to hormonal changes that thin the vaginal walls. This thinning reduces the cells available to produce moisture, leading to dryness. The main factor contributing to this condition is a decrease in estrogen levels, which is a common aspect of the menopausal transition. The genitourinary syndrome of menopause (GSM) is a term that describes various menopausal symptoms and signs associated with physical changes of the vulva, vagina, and lower urinary tract. GSM includes not only genital symptoms (dryness, burning, and irritation) and sexual symptoms (lack of lubrication, discomfort or pain, and impaired function), but also urinary symptoms (urgency, dysuria, and recurrent urinary tract infections [UTIs]). [2]

What Can You Do About Vaginal Dryness in Menopause?

Vaginal dryness due to menopause can be uncomfortable and even painful, but there are treatments available, both over-the-counter and prescription. Medical treatments that can be prescribed for you include:

Symptom Relief Strategies:

• Vaginal moisturizers and lubricants: Utilize lubricants to minimize discomfort during intercourse.

Vaginal Estrogen Therapy:

To alleviate vaginal dryness and discomfort, vaginal estrogen is available in various forms, including:

• Vaginal Estradiol Tablets
• Vaginal Gels & Creams
• Vaginal Suppositories or Rings.
• Studies have shown there is no evidence of increased early breast cancer risk in patients who used vaginal estrogen therapy, compared with patients who did not use HRT. [2] That said, always consult with a healthcare provider to understand your personal risks and benefits.
• Standard doses of estrogen therapy can also be combined with vaginal creams.

Non-Hormonal Treatments:

• Prasterone (Intrarosa): This vaginal insert is a non-estrogen treatment that provides dehydroepiandrosterone (DHEA) to the vagina, alleviating vaginal dryness and pain during intercourse due to GSM.
• Ospemifene (Osphena): A daily pill that eases painful intercourse for women with moderate to severe GSM, not recommended for those at high risk for breast cancer.

References:

1. Kim HK, Kang SY, Chung YJ, Kim JH, Kim MR. The Recent Review of the Genitourinary Syndrome of Menopause. J Menopausal Med. 2015 Aug;21(2):65-71. doi: 10.6118/jmm.2015.21.2.65. Epub 2015 Aug 28. PMID: 26357643; PMCID: PMC4561742.
2. McVicker L, Labeit AM, Coupland CAC, Hicks B, Hughes C, McMenamin Ú, McIntosh SA, Murchie P, Cardwell CR. Vaginal Estrogen Therapy Use and Survival in Females With Breast Cancer. JAMA Oncol. 2024 Jan 1;10(1):103-108. doi: 10.1001/jamaoncol.2023.4508. PMID: 37917089; PMCID: PMC10623297.

The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.