What is it?
Vaginal dryness is a common problem for women during and after menopause, although inadequate vaginal lubrication can occur at any age. Vaginal dryness is a hallmark sign of vaginal atrophy (atrophic vaginitis) — thinning and inflammation of the vaginal walls due to a decline in oestrogen. Along with vaginal dryness, you might also have itching and stinging around the vaginal opening and in the lower third of the vagina.
Vaginal dryness can make intercourse uncomfortable. Most vaginal lubrication consists of clear fluid that seeps through the walls of the blood vessels encircling the vagina. When you're sexually aroused, more blood flows to your pelvic organs, creating more lubricating vaginal fluid. But the hormonal changes of menopause, childbirth and breast-feeding may disrupt this process.
Vaginal dryness may be accompanied by signs and symptoms such as:
- Pain or light bleeding with sex
- Urinary frequency or urgency
A thin layer of clear fluid coats your vaginal walls. Most of this lubrication seeps through the walls of the blood vessels encircling the vagina. Hormonal changes during your menstrual cycle and as you age affect the amount and consistency of this moisture. A variety of conditions contribute to vaginal dryness. They include:
Decreased oestrogen levels
Reduced estrogen levels are the main cause of vaginal dryness. Oestrogen, a female hormone, helps keep vaginal tissue healthy by maintaining normal vaginal lubrication, tissue elasticity and acidity. These factors create a natural defense against vaginal and urinary tract infections. But when your estrogen levels decrease, so does this natural defense, leading to a thinner, less elastic and more fragile vaginal lining.
Oestrogen levels can fall for a number of reasons:
- Menopause or perimenopause
- Effects on your ovaries from cancer therapy, including radiation therapy, hormone therapy and chemotherapy
- Surgical removal of your ovaries
- Immune disorders
- Cigarette smoking
Allergy and cold medications, as well as some antidepressants, can decrease the moisture in many parts of your body, including your vagina. Anti-oestrogen medications, such as those used to treat breast cancer, also can result in vaginal dryness.
In this autoimmune disease, your immune system attacks healthy tissue. In addition to causing symptoms of dry eyes and dry mouth, Sjogren's syndrome can also cause vaginal dryness.
The process of cleansing your vagina with a liquid preparation (douching) disrupts the normal chemical balance in your vagina and can cause inflammation (vaginitis). This may cause your vagina to feel dry or irritated.
Diagnosis of vaginal dryness may involve:
- Pelvic exam. Your doctor visually inspects your external genitalia, vagina and cervix and inserts gloved fingers into your vagina to feel (palpate) your pelvic organs for signs of disease.
- Pap test. Your doctor collects a sample of cervical cells for microscopic examination. He or she may also take a sample of vaginal secretions to check for signs of vaginal inflammation (vaginitis) or to confirm vaginal changes related to oestrogen deficiency.
- Urine test. You provide a urine sample to be analyzed for urinary conditions, if you have associated urinary symptoms.