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Vaginal Dryness

When your vagina isn't properly lubricated, it can feel itchy and irritated. Vaginal dryness may make some daily activities uncomfortable, and it can make sexual intercourse less pleasurable. In fact, during menopause, vaginal dryness is a common cause of discomfort or pain during sex (dyspareunia).

Vaginal dryness is a common condition. It can affect women of all ages, though vaginal dryness most often occurs during and after the menopausal transition. An estimated 10 percent to 40 percent of women who've reached menopause have signs and symptoms related to vaginal dryness.

A number of self-care measures and medical treatments can help you reduce vaginal dryness.

A variety of conditions can cause vaginal dryness. Determining the cause is key to helping you find an appropriate solution. Potential causes include:

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.

Estrogen levels can fall for a number of reasons:
  • Menopause or 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
Allergy and cold medications, as well as some antidepressants, can lead to dryness of mucous membranes, including those of your vagina.

Sjogren's syndrome
In this autoimmune disease, your immune system attacks healthy tissue. In addition to causing symptoms of dry eyes and dry mouth, Sjogren's syndrome can also cause vaginal dryness.

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.

Aside from dryness, some of the signs and symptoms include :
  • Itching
  • Burning
  • A feeling of pressure
  • Pain or light bleeding with sex
  • Urinary frequency or urgency
A pelvic exam is one way your doctor evaluates and diagnoses vaginal dryness. He or she may take a sample of cervical cells or vaginal secretions for examination under the microscope or to send to the laboratory for other testing. You may also be asked for a urine sample for testing if you have associated urinary symptoms.

Vaginal estrogen therapy
If vaginal dryness is due to a lack of adequate estrogen and if self-care measures don't correct the problem, vaginal estrogen therapy may be helpful. Vaginal estrogen therapy comes in several forms:
  • Vaginal estrogen cream (Estrace, Premarin, others). You insert this cream directly into your vagina with an applicator, usually at bedtime. Your doctor will let you know how much cream to use and how often to insert it, generally two or three times a week.
  • Vaginal estrogen ring (Estring). A soft, flexible ring is inserted into the upper part of the vagina by you or your doctor. The ring releases a consistent dose of estrogen while in place, and needs to be replaced about every three months.
  • Vaginal estrogen tablet (Vagifem).You use a disposable applicator to place a vaginal estrogen tablet in your vagina. Your doctor will let you know how often to insert the tablet, usually twice a week.

If vaginal dryness is associated with other symptoms of menopause, such as moderate or severe hot flashes, your doctor may suggest estrogen pills, patches, gel or a higher dose estrogen ring. Talk to your doctor to decide if estrogen treatment is an option and, if so, which type is best for you.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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