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Diseases & Conditions > Menopause

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What's Causing Your Vaginal Dryness

Sheryl Kraft

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A dry vagina is an uncomfortable vagina. And, because people rarely talk about vaginal dryness, you can feel like you're the only one with this problem.

But you're not: More than half of postmenopausal women deal with the condition, which can cause burning, itching, irritation, urinary problems and problems with sex and exercise.

There's a connection between vaginal dryness and the hormone estrogen: as the hormone declines—which happens with menopause—so does the quality of your vaginal lining. As a result, rather than remaining smooth and plump, the vagina becomes dry.

And when it's dry, it's more prone to irritation. It can itch, burn and even feel sore and tender. The dryness can also cause pain during urination (and an increase in urinary tract infections) and micro-tears in the tissue, leading to bleeding, most likely during sex and exercise.

Which is to say that even though having a dry vagina is common among postmenopausal women, it can still have a very big impact on your life, affecting things from your choice of clothing to your sex life.

But menopause and the ensuing loss of estrogen are not the only causer of vaginal dryness. Childbirth, breastfeeding, some immune disorders and cancer treatments, surgery to remove the ovaries, smoking and some anti-estrogen medicines can all take their toll on estrogen. Additionally, some antidepressants and cold or allergy medicines can also cause vaginal dryness or reduced vaginal secretions, as can douches and some soaps, lotions and perfumes.

There are things you can do. The North American Menopause Society recommends ditching the soap and using just plain water for cleansing. Other options you can try include:

• Over-the-counter vaginal lubricants and moisturizers.

• Prescription low-dose oral estrogen therapy.

• Topical low-dose estrogen creams or suppositories inserted directly into the vagina (currently the gold standard). These can restore the vagina's thickness and flexibility with minimal absorption of estrogen into the rest of your body.

• Vaginal laser treatments, which can increase blood flow and support the growth of new, healthy tissue.

• Using white, unscented toilet tissue.

• Washing your underwear in detergents free of dyes and perfumes.

• Avoiding fabric softeners or anti-cling laundry products.

If you're hoping to use an alternative approach to vaginal dryness such as eating soybeans or using products containing wild yam or black cohosh, research is ongoing, but the jury is still out.

A dry vagina can make sex too painful to contemplate, but the more sex you have, the better off you'll be, because regular vaginal sexual activity helps maintain the vagina's blood flow and its length and elasticity.

Although over-the-counter lubricants and moisturizers can help ease everyday discomfort or pain during intercourse, they may not always be enough. That's when it's a good idea to visit your health care provider to discuss your other options.

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