Vaginal dryness is a common complaint that most women will encounter at some point in time in their life. It is commonly caused by a falloff in circulating oestrogen levels which occurs as women get older. However, vaginal dryness can occur at any age. 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. It is estimated that only 25% of women with vaginal dryness seek treatment. This should not be the case.

Causes
There are 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.
● Suboptimal 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
● Yeast infections
● Bacterial vaginosis 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
● Extended foreplay leading to heightened arousal before sexual intercourse
● Regular sexual activity

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

When to see a doctor

● If you have used a water-soluble lubricant and the vaginal dryness persists
● It’s impacting your overall quality of life
● Affecting the relationship with your partner
● There is an unusual vaginal odor or discharge
● Unexplained vaginal bleeding

Take away points
● Vaginal dryness is quite common and it is underreported in up to 75% of instances.
● 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.
● Your partner should be involved, where applicable, in the diagnosis and management
● Successful treatment can significantly improve your self-confidence and quality of life

Author’s contact Information: Dr. C. Malcolm Grant – Family Physician, c/o Family Care Clinic, Arnos Vale. To make an appointment: 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, diagnosis, 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.