Vaginal Dryness During The Menopause

Around the time of menopause more than half of all women will have some sort of problem involving vaginal dryness and itching. It affects more than 80% of women just entering menopause and continues to affect up to 50% of those completing menopause. Even before the levels of oestrogen start to fall significantly, some women notice that less lubrication is produced during intercourse, and sexual arousal is more difficult.

They may attribute this to tiredness and or loss of interest, but the mucous membranes around the genitals are actually changing. There are a number of very good remedies apart from hormones, for vaginal dryness, but itching normally signals an infection that will require a doctors attention.

What Causes Vaginal Dryness?

Your vagina is kept moist by mucus membranes that are located at the mouth of your uterus. Oestrogen in your body aids these membranes in producing lubrication that helps to keep the vagina moist, supple, and strong. The lubricant also has a slight acidity level, which helps to protect your vagina from foreign bacteria, keeping it free from infection.

The epithelial tissue in the vagina is dependent on oestrogen and, in the absence of the hormone, this protective layer thins or disappears altogether making it more prone to damage if extra lubrication is not used during sexual intercourse
Acid levels also begin to decline, leaving you open to invading microorganisms, which can cause yeast infections and urinary tract infections.

The lubrication of the vagina is also affected by circulation, as a lot of the moisture is produced by fluid seeping out of blood vessels and into the vagina rather than direct secretion from glands. When there is not enough lubrication, intercourse can lead to irritation, pain and post-coital bleeding. If you experience discomfort or bleeding during or after intercourse it is important to do something about it.

Non-Menopausal Causes

Any medicines warning of a dry mouth as a side effect are going to dry out all mucous membranes, including those in your vagina. Antihistamines are the biggest culprit. Many antidepressants can decrease libido and thus affect lubrication.
If you notice dry eyes, nose and mouth as well as a dry vagina it is important to check that you don't have an autoimmune disorder known as Sjogrens syndrome. Your doctor will need to d a blood test to diagnose this and the symptoms can be treated with lubricants, artificial tears and saliva.

Liquid douche preparations can disrupt the normal chemical balance and may lead to vaginal dryness.

Symptoms of Vaginal Dryness

The most common symptoms of vaginal dryness are itching and painful sexual intercourse. Without its natural mucus, the vagina becomes very dry and fragile and cannot handle rough penetration. Forceful penetration may rip or tear the vaginal walls. You may have been wondering why you are experiencing vaginal bleeding after menopause. Spotting or bleeding can occur after sex if the vagina is too dry. A lot of women cannot stand to have sex at all, because the painful intercourse in menopause is simply not enjoyable.

Menopause itching due to dryness can also become painful and annoying. Incontinence also often occurs with vaginal dryness. As oestrogen levels decrease, the walls of your vagina become increasingly weak, and are unable to prevent urine from escaping. Women with vaginal dryness are also at increased risk for developing vaginal infections like yeast infections, which are characterized by a thick, odorous discharge.

Treatments for Vaginal Dryness

Relieving vaginal dryness is possible. There are a variety of treatments are available to women suffering from vaginal dryness.

• Vaginal Lubricants: There are now many lubricants commercially available that can help. Sometimes a special vaginal moisturizer – like Replens – is adequate, but if more lubrication is required a lubricant like KY jelly may be recommended. The brands are all slightly different so try a few before deciding on the one that is best suited to your needs. Lubricants can be applied up to two hours before sexual intercourse. Over the counter moisturizers can provide relief from dryness for up to 24 hours.

• Always use a water soluble lubricant if you are using condoms as oil based lubricants can damage the condom.

• Hormone treatments: For persistent vaginal dryness oestrogen therapy is recommended. Oral, topical, transdermal, and tablet forms are available by prescription from your doctor.

• Creams result in significant levels of oestrogen entering the blood because oestrogen is easily absorbed through the vaginal walls. They are used with an applicator and are applied daily at first and then less frequently. Creams can be messy and are sometimes avoided for long term use. In these cases a vaginal ring may be preferable. The ring can stay in the vagina, delivering constant dose of oestrogen for up to three months. Some women prefer to remove it before sex and then replace it afterwards.

• Diet: Phytoestrogens, particularly isoflavones found in soya products, produce a mild oestrogen like effect and may be helpful in increasing moisture in the vagina. Make sure you drink plenty of water. If your urine is dark and yellow and has a strong smell, or if you pass urine fewer than four times a day, you may need to increase your fluid intake.

• Herbal Remedies: Black cohosh is widely used by many women to reduce other symptoms of menopause as well as vaginal dryness. A topical preparation made from licorice root is also sometimes used.

• Homeopathic Treatments: Bryonia 6c and lycopodium 30c are the two remedies most frequently used.

If treatment is started early the vaginal tissue is quickly returned to normal. If treatment is delayed improvement will take longer.

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