One in two women will experience vaginal dryness to some degree after the menopause according to medical website Patient UK. It can be distressing and embarrassing and many women don’t seek medical help putting it down to the menopause and aging. HRT is an effective treatment but there are many holistic options if you don’t want to go down that route.
Causes of Vaginal Atrophy
‘Atrophy’ means to waste away and ‘vaginitis’ – inflammation of the vagina. It is caused by a decline of oestrogen in the body during the perimenopause. Due to hormonal changes the vaginal tissue is less oxygenised and there is less blood flow. The vagina shortens, becomes thinner and loses some of its inner folds. When oestrogen levels are normal tiny glands on the cervix generate mucus, which keeps the vagina moisturised. Post-menopause we have fewer of these glands so less moisture coating the vaginal tissues, which can lead to dryness and irritation.
Oestrogen also has protective qualities because it makes the cells produces glycogen, a protein that protects against infection. This is why menopausal women often suffer from urinary tract infections.
Although vaginal dryness mostly affects women who are menopausal it has also been linked to other factors – stress, using tampons, breastfeeding, PMS (you may notice you are drier at certain times of your menstrual cycle) and vaginal douching. It can also be caused by certain medications such as anti-depressants, antihistamines and the contraceptive pill.
Symptoms of Vaginal Atrophy
A woman may experience one or several of these, to varying degrees: -
- Vaginal dryness.
- Pain during sex (dyspareunia).
- Changes in appearance of the labia and vagina – it looks paler and thinner.
- Irritation when wearing certain clothes such as tight jeans or when doing certain activities.
- An increase in urinary tract infections. You may also feel the urge to go to the loo more frequently.
- Itching and scratching cycle.
- Mental stress and lack of libido because you anticipate painful sex.
- Vaginal discharge.
Treatments for Vaginal Atrophy
Treatment depends on what is causing the most problems and needs to be tailored to the individual. Machelle Seibel, Professor of Obstetrics & Gynaecology at the University of Massachusetts Medical School explains the following options: -
- Hormone Replacement Therapy (HRT) can be taken as a tablet, gel, patch or implant, which supplies oestrogen to the whole body. It is effective although there is debate about the risks of taking it in the long-term. Localised HRT is another option - vaginal tablets, creams, rings and pessaries can be taken internally to supply oestrogen to the vaginal area only.
- Lubricating gels – Yes organic lubricants and Replens are two popular options. The Yes water-based lubricant remoisturises the vaginal tissues and can improve sensation during sex.
- Diet & exercise - regular exercise is important as it keeps blood flow and genital circulation high. Experiment with your diet - soy isoflavones (plant oestrogens), linseeds, fish oils, and black cohosh have been found to be helpful. Marrena Lindberg's book The Orgasmic Diet explains this in more detail.
- Homeopathic remedies such as belladonna, bryonia and lycopodium may help - consult a qualified homepath for advice.
- Make sex and masturbation a priority as this will help the tissues to lubricate - increase foreplay and give your body time to respond.
Vaginal dryness is a common, chronic condition that occurs for various reasons - the menstrual cycle, contraceptive pill, lack of libido, and during menopause. It can be treated holistically and medically. Speak to your doctor about the best options for you.
Resources
The Orgasmic Diet: Boost Your Libido and Achieve Orgasm by Marrena Lindberg, Piatkus 2007.
This article is for general information purposes only. Consult your health practitioner for specific guidance on a health issue.
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