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:
When to see a doctor
Conditions that contribute to vaginal dryness include those below.
Decreased estrogen levels
Estrogen levels can fall for a number of reasons:
Preparing for your appointment
If your primary doctor is a family doctor or general practitioner, he or she may refer you to a specialist (gynecologist) to evaluate your condition.
What you can do
For vaginal dryness, some basic questions to ask your doctor include:
Don't hesitate to ask questions during your appointment anytime you don't understand something.
What to expect from your doctor
Tests and diagnosis
Diagnosis of vaginal dryness may involve:
Treatments and drugs
In general, treating vaginal dryness is more effective with topical (vaginal) estrogen rather than systemic estrogen given orally or by skin patch. Estrogen applied to the vagina can still result in estrogen reaching your bloodstream, but the amount is minimal, especially if a low dose is used.
Vaginal estrogen doesn't decrease testosterone levels — important for healthy sexual function — the same way oral estrogen can. Vaginal estrogen therapy may also reduce the risk of urinary tract infections.
Talk with your doctor about what dose and what product is appropriate for you. Vaginal estrogen therapy comes in several forms:
If vaginal dryness is associated with other symptoms of menopause, such as moderate or severe hot flashes, your doctor may suggest systemic estrogen, along with a progestin if you have not had your uterus removed (hysterectomy). Systemic estrogen can be given as pills, patches, gel or a higher dose estrogen ring.
Talk to your doctor to decide if hormone treatment is an option and, if so, which type is best for you. If you have a history of breast, ovarian or cervical cancer, vaginal estrogen therapy may still be an option, but discuss the risks and benefits with your doctor.
Lifestyle and home remedies
Consider using a lubricant or moisturizer
Before using complementary or alternative treatments, such as vitamin therapies or products containing estrogen, talk to your doctor about the product's safety and effectiveness.
Pay attention to sexual needs
Avoid certain products
Also avoid using scented or perfumed products, including toilet paper and detergents.
Last Updated: 2012-12-21
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