Vaginal dryness is a prevalent condition affecting many women, particularly those who have undergone menopause. It arises due to the thinning of vaginal walls and reduced natural lubrication. This discomfort can impact daily life, sexual activities, and interpersonal relationships.
1. Hormonal Changes: The primary culprit for vaginal dryness is hormonal fluctuations. Oestrogen, for instance, ensures the vagina is well-lubricated. An imbalance in oestrogen levels can lead to dryness. Such imbalances can occur during:
• Menopause
• Breastfeeding
• Certain medications like contraceptives and specific antidepressants
• Treatments to decrease oestrogen levels (for conditions like fibroids or endometriosis)
• Surgical removal of womb and ovaries
• Cancer treatments like chemotherapy or radiotherapy.
2. Non-Hormonal Causes:
• Using douches or very hot baths, which can deplete the vagina’s natural oils.
• Sjögren’s Syndrome, a rare autoimmune condition.
• Insufficient arousal prior to sexual activity.
• Itching or soreness in the lower vagina or vulva.
• Pain or discomfort during intercourse.
• Minor bleeding post-intercourse.
• Increased susceptibility to urinary tract infections (UTIs).
• Frequent or urgent urination.
• Thinning of the vaginal lips (labia).
Around 10% of women with itching due to vaginal dryness report worsening symptoms during the night. Possible reasons include:
• A rise in body temperature at night, increasing itchiness.
• The body’s circadian rhythm triggering chemicals that heighten irritation.
• Night-time dehydration, drying the skin further.
For those who face nocturnal itching, antihistamines like Piriton might offer relief and aid in sleep.
1. Vaginal Tablets (Vagifem): Vagifem offers relief by replenishing oestrogen in vaginal tissue. Typically, it involves daily insertion for two weeks, followed by bi-weekly use. It may take 8–12 weeks to realise its full benefit.
2. Oestrogen Creams & Pessaries: Estriol, Ovestin, and Vagifem pessaries are available treatments post-menopause. If eligible, they can be ordered from online health platforms. These are not suitable for everyone; certain conditions or risks, including history of breast cancer or clotting disorders, may preclude their use.
3. Vaginal Moisturisers: Products like Vagisan can alleviate symptoms, especially for those hesitant or unable to use hormonal treatments. Ensure that the chosen moisturiser is intended for internal use.
4. Lifestyle & Over-the-Counter Measures: Avoid perfumed soaps or douches, use water-based lubricants during intercourse, or try vaginal moisturisers like Replens
• Always read the Patient Information Leaflet accompanying medicines.
• Disclose any medicines you’re taking and your medical history to ensure treatments like Vagifem are appropriate.
• If there’s no improvement after three months of treatment, or symptoms worsen in two, consult a healthcare professional.
• If you experience vaginal bleeding, consult a doctor urgently.
• Confusion between vaginal dryness and cystitis symptoms is common; if in doubt or if treatment isn’t effective, see a doctor.
• Long-term use of treatments is possible if needed, but always under medical guidance.
While vaginal dryness can be challenging, a range of treatments can bring relief. It’s essential to consult with a healthcare professional to find the most suitable solution. Remember, you don’t have to live with the discomfort; help is available.