During menopause, estrogen production slows down and then stops. When this happens, a lot of changes take place in a woman’s body – and some of them are undesirable. Menstruation becomes irregular and then stops. Hot flushes, sweating, mood swings, sleep disturbances, voice deepening, facial hair growth, chronic fatigue, dysuria, decreased sexual mood, vaginal dryness, etc. may occur.
Vaginal dryness is a common symptom of menopause. Nearly one in three women suffers from vaginal dryness as they experience this stage. It appears even more often after menopause, although it may occur at any age due to various causes.
What causes vaginal dryness?
Normally, the vaginal walls are lubricated with a thin layer of pure liquid. Estrogen, a female hormone, helps maintain vaginal lubrication and regulate its acidity, as well as maintains the health and elasticity of the vaginal tissue. During menopause, the decrease in estrogen levels results in insufficient vaginal lubrication while at the same time thinning the vaginal tissue and making it less elastic. This is called vaginal atrophy.
Estrogen levels may also be reduced by causes other than menopause, such as:
childbirth and breastfeeding.
radiation therapy or chemotherapy for cancer.
surgical removal of the ovaries.
anti-estrogen drugs used to treat uterine fibroids or endometriosis.
Other causes of vaginal dryness include:
Sjögren’s syndrome (autoimmune disorder affecting the exocrine glands).
allergies, cold medication and some antidepressants.
incorrect hygiene practices around the sensitive vaginal area such as the use of showers, shower gels, aromatic soaps and lotions. These products can aggravate dryness.
Regardless of the cause, vaginal dryness can be extremely disturbing. It may cause itching, burning sensation and dyspareunia (painful sexual intercourse).
How is diagnosis made?
You should contact your doctor or gynecologist for any burning sensation, itching or irritation in the area of the vagina. The doctor will receive your health history and will want to know how long you have experienced the specific symptoms, and if anything – such as washing or taking medication – seems to aggravate it. He will alsoperform a pelvic exam, controlling your vagina for thinning or erythema. Examination will help him rule out other possible causes for your discomfort, including a urinary tract infection. The doctor may also perform a Pap test by removing and controlling cells from the vaginal walls or the cervix.
How is vaginal dryness treated?
A common treatment for vaginal dryness due to low estrogen levels is local Hormone Replacement Therapy. Such a local treatment replaces some of the hormones the body no longer produces. This helps alleviate the symptoms of the vagina but does not introduce as much estrogen into the bloodstream as Oral Hormone Replacement Treatment.
Any type of product for local Hormone Substitution Treatment (estrogen vaginal ring, estrogen vaginal tablet, estrogen vaginal cream) can have side effects such as vaginal bleeding and chest pain. Local Hormone Replacement Treatment is not recommended for women who:
have breast cancer, especially if they are taking an aromatase inhibitor.
have a history of endometrial cancer.
have undiagnosed vaginal bleeding.
are pregnant or lactate.