Unmask the Myths About Vaginal Dryness
A woman stands in the feminine-product aisle at the store—eyes shifting nervously from the Kotex to the K-Y Jelly. She wants to pick up the K-Y, but she doesn’t want anyone, including the checkout guy, to know about “her” problem (whisper—it’s vaginal dryness).
The myth is that this problem is hers alone. The marvel is that there’s lots she can do about it.
MYTH: Other women aren’t having this problem.
If you’re dealing with vaginal dryness, the first thing you should know is that you’re not alone. The discomfort, sometimes accompanied by soreness, itching or burning sensations (especially during or after intercourse), is, unfortunately, a common condition.
Nearly half of all women over 40 experience vaginal dryness, and that number grows when you add in younger women who have recently had a baby. Lower estrogen levels are generally to blame, says Virtua obstetrician/gynecologist Michele Godorecci, MD. “Estrogen keeps the vagina healthy by promoting blood flow and ensuring that its cells are plump and oxygenated. When estrogen decreases, and that blood flow is not as robust as it once was, cells shrink, the vagina sometimes shrinks, and dryness occurs.”
MYTH: There's nothing I can do about it.
Good news—there’s actually quite a lot you can do to alleviate the discomfort of vaginal dryness. Potential treatments range from home remedies to prescription medications.
First things first: Are you drinking enough water? Your body needs water in order to produce its lubricating secretions—think tears, sweat, saliva, and, yes, vaginal fluid. “Water intake is crucial for the proper functioning of any organ system in our bodies,” says Dr. Godorecci. “Certainly, this doesn't exclude the vagina.”
Next, you might take some time to familiarize yourself with the range of over-the-counter personal lubricants available. A growing number of brands and product lines provide opportunities to experiment with different water- and silicone-based formulas to find the one that works best for you. Rather than endorsing one type of lubricant over another, Dr. Godorecci says that “choosing the best lubricant is a trial-and-error process. What works for one woman may not work for another. Some women may have sensitivity to silicone-based products. Others may want to try coconut, mineral or olive oil first.”
If persistent or acute dryness is an issue for you, your doctor can suggest a course of prescription treatment. Topical (vaginal) estrogen may be among the options available to you. “The benefit of estrogen therapy is that it addresses the underlying problem, and not just the symptoms. Vaginal estrogen comes in many forms—suppositories, creams, rings that are inserted into the vagina—and very little is absorbed in your system. For a woman how hasn’t had her uterus removed through hysterectomy, progestin is also given with estrogen to protect the uterine lining against cancer.”
And, if you’re experiencing severe menopause symptoms that extend beyond vaginal dryness, you may want to explore oral or topical estrogen therapy.
Estrogen therapy isn't recommended for women with a history of or risk for cancer or blood clots, but women should still discuss other treatment options with their doctor.
While it’s not officially approved by the American College of Obstetrics and Gynecology to treat vaginal dryness, Dr. Godorecci has found that testosterone is helping improve the sex lives of her patients dealing with vaginal dryness: “Testosterone is also produced by the ovaries, and is needed for a healthy sex drive. When applying a testosterone cream to the skin or clitoris, some will absorb and boost sex drive, and some will convert into estrogen.” While studies are still in progress to investigate the role of testosterone therapy in treating vaginal dryness and other symptoms of menopause, Dr. Godorecci suggests discussing this option with your doctor. She says she’s had “many patients opt to try this approach over the past few years with a good degree of success.”
Bioidentical hormone replacement therapy
One option getting a lot of attention is bioidentical hormone replacement therapy. Bioidentical hormone replacement therapy is different from mass-manufactured hormone replacement therapies. It is made up of biologically identical hormones that are plant-based compounds with a molecular structure similar to the human body. Through bioidentical pellets placed painlessly beneath the skin, Exuberan replenishes the testosterone and estrogen that women progressively lose after they reach their mid-40s. It balances the hormones that help women feel energized and focused and improves libido and sexual performance.
Serum estrogen receptor modulator (SERM)
Another option is the serum estrogen receptor modulator (SERM), Osphena. “This newer oral medication was initially investigated to treat osteoporosis,” says Dr. Godorecci. “During the trial, the researchers noted that it was alleviating the participants’ vaginal dryness issues. So they switched gears and ran trials to study its efficacy in treating decreased vaginal lubrication and inflammation. And, they had good success.” As with estrogen, there’s a risk for blood clots, so women need to discuss this risk with their gynecologist.
MYTH: Talking about it with my doctor will be embarrassing.
While it may be initially uncomfortable to raise the issue of vaginal dryness with your doctor, it’s a conversation well worth having. “You’re not going to surprise your doctor,” assures Dr. Godorecci. “We’re all aware that vaginal dryness is a big issue for women, and we’re all helping our patients deal with it. You’re not alone and you don’t have to settle for discomfort or a disrupted sex life.”
Updated June 6, 2016