Q: I am 45 and suffer from vaginal dryness. Sex is very painful and no longer enjoyable. My relationship has suffered. I am embarrassed and depressed. What could be the cause and how can this be treated?

Vaginal dryness is most commonly caused by a falloff in circulating oestrogen which occurs as women get older. Oestrogen helps to maintain healthy vaginal tissue, which in turn supports lubrication and the expansion of the vagina, especially immediately before and during sexual intercourse. Unfortunately, vaginal dryness often goes untreated because many women are too embarrassed to discuss this issue with their partner or doctor. This should not be the case.

Causes

There is a wide array of causes of vaginal dryness. These include:

•  Menopause
• Peri-menopause
• Hysterectomy
• Medications: e.g. birth control, antihistamines, decongestants, cold medications, sedatives, certain antidepressants, some blood pressure, and heart medications, etc.
• Sub-optimal intake of essential fatty acids – found in nuts, whole grains, avocado, fatty fish, kidney beans, etc.
• Cigarette smoking
• Douching
• Loss of interest in sexual intercourse
• Diabetes
• Some autoimmune disorders – e.g. Sjogren’s Syndrome
• Anti-oestrogen medicines
• Anxiety/ depression
• Stress
• Pelvic radiation
• Chemotherapy
• Surgical removal of the ovaries
• Pregnancy
• Breast-feeding
• Excessive exercising
• Exposure to swimming pool chemicals

Consequences of vaginal dryness

• Painful sexual intercourse
• Vaginal soreness, burning, itching, stinging and spotting – especially during and after sex
• Pain in the vagina when peeing, standing, sitting, exercising
• Urinary frequency
• Recurrent urinary tract infections
• Loss of interest in sexual intercourse
• Spasm of the vagina (vaginismus)
• Depression/ anxiety
• Relationship issues
• Loss of self-confidence

Treatment of vaginal dryness

Fortunately, there are many treatment modalities for vaginal dryness. Common treatment options include:

• Avoiding the use of perfumed products, for example, soaps, sprays, and lotions, in or near the vagina.
• Using oestrogen and non-oestrogen medications
• Increasing the consumption of foods with phytoestrogens – e.g. garlic, yams, sweet potatoes, peanuts, cabbage, broccoli, oranges, etc.
• Vaginal insertion of conjugated-based oestrogen creams
• Insertion of water-based unscented vaginal lubricants and moisturizers
• Insertion of pure natural oil such as coconut or olive oil at the time of intercourse*
• Avoiding bubble baths, bath salts, and scented oils.
• Avoid using hot water when washing the vaginal area
• Avoiding douches
• Avoiding scented wipes in the area
• Avoiding brands of condoms that contain nonoyxnol-9, or N-9
• Being well hydrated, especially in our tropical climate.

It must be noted that mineral oils (and petroleum jelly) can damage and compromise latex condoms and diaphragms that are used for birth control.

Take away points

•  Vaginal dryness is quite common and it is very underreported.
• There is no need to be embarrassed about this condition.
• There are a wide range of causes
• Most cases do not have a serious cause and can be prevented or successfully treated
• If symptoms persist after home treatment, your doctor should be consulted.
• Work with your doctor to manage this problem.
• our partner should be involved, where applicable, in the diagnosis and management
• Successful treatment can significantly improve your self-confidence and quality of life.

Author: Dr. C. Malcolm Grant – Family Physician, c/o Family Care Clinic, Arnos Vale, www.familycaresvg.com, clinic@familycaresvg.com, 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp)
Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.