Menopause and Vaginal Dryness
Feeling dryer than the Sahara Desert?
Vaginal dryness is a common symptom that many women will experience as they go through menopause and something that can last well into post-menopause. Not only is it generally uncomfortable but it also makes sexual relationships become more difficult due to the absence of the body’s ability to produce the natural lubrication that is required in a sexual encounter. This can become frustrating and in turn can decrease sexual desire because the experience is no longer enjoyable for the woman.
Besides the sexual issues that occur with vaginal dryness, it can result in burning, itching, soreness and cause standing, sitting, exercise and urination to become painful. The secretions that are produced in the vaginal region are also protective against pathogenic organisms due to the pH that is maintained by these secretions. Changes in the vaginal pH can result in overgrowth of yeast, resulting in yeast infections or bacterial overgrowth causing bacterial vaginosis or urinary tract infections.
So what causes Vaginal dryness?
Our body produces very important hormones that impact a number of functions in our body. When a woman enters menopause these hormones begin to decline. As I have discussed in many past blogs women produce estrogen and progesterone, which are two key hormones that control not only the menstrual cycle but also our mood, sleep, libido, metabolism and the vaginal secretions produced by the vagina.
When estrogen levels drop, this results in thinning of the vaginal mucous membrane and atrophy of the vaginal wall. Estrogen plays an important role in maintaining blood flow to the vagina, clitoris and urethra. Decline in estrogen will lead to a decline in the blood flow to these regions, which also contributes to these tissues being compromised. Estrogen also maintains the pH in the vagina and a decline in the serum levels of estrogen results in a less acidic environment which leaves the vagina open to the risk of vaginal infections, urinary tract infections and urinary incontinence.
Testosterone plays a role here as well, in that it aids in maintenance of the muscle tone of the vagina. Lack of testosterone will result in decreased muscle tone of the vagina and decreased sensitivity in this region, which in turn decreases production of vaginal secretions.
So what can you do?
In the past women just accepted vaginal dryness as part of the aging process and suffered in silence. It was and to some degree is still considered the norm that as we age sexual intercourse is not part of the picture anymore. It doesn’t have to be this way! There are many options that are available to prevent and improve vaginal dryness and the issues that surround this problem.
There are hormonal options that can be used successfully and that don’t need to be used long term, but can be utilized initially to aid in restoring the integrity of the vaginal tissue. Bioidentical estriol suppositories have been shown to be a safe and effective treatment option for vaginal dryness. In severe cases of vaginal dryness this treatment is likely the best option but seeking medical advice is necessary to ensure this is the right option for you.
There are also many non-hormonal treatment options that are just as effective as the hormonal options. Hyaluronic acid suppositories have been shown to aid in healing the vaginal mucosa and improve the integrity of the vaginal wall tissues. It also aids to maintain the acidic pH of the vagina, thus preventing the risk of infection.
Vitamin E and Vitamin D are two fat soluble vitamins that have been shown to improve the integrity of the vaginal tissue and applied locally can aid to improve vaginal dryness.
There is also a study using a combination of hyaluronic acid, liposomes, phytoestrogens from Humulus lupulus (Hops) extract and Vitamin E combined as a topical vaginal gel that have been shown to improve vaginal dryness and considered to be a safe alternative to hormonal options.
Botanical phytoestrogens that are administered orally have also been shown to improve vaginal dryness over a 3-6 month period. In particular, Red clover, Hops and Siberian Rhubarb have all been shown to significantly improve vaginal dryness as well as other symptoms commonly associated with menopause.
Vaginal dryness affects 40-50% of women as they go through menopause. If you are experiencing this, there is no need to suffer. There are a number of treatment options available to get you back on track. Talk to your medical provider to determine what the best options are for you.