Vaginal dryness is very common, however it's not something that you might chat with your girlfriends about. Many women are even hesitant to raise this topic with their doctor.
But please don't suffer in silence thinking vaginal dryness is a normal part of ageing, because the earlier you seek help, the easier it is to support your vaginal tissue and moisture levels.
A dry vagina has fragile tissue which has become thinner and less elastic. Dryness can be very uncomfortable or very painful. Everyday activities such as wiping after using the toilet, walking, or exercise can cause inflammation and soreness.
Vaginal dryness can disrupt your sex life by causing pain and light bleeding from cuts and tears. It's not uncommon for women to experience more frequent urinary tract infections with vaginal dryness.
So what can you do about a dry vagina? Before you reach for estrogen supplements or even the natural remedies, it's important to work out what's contributing to the dryness in the first place.
What could be causing your vaginal dryness?
It turns out there are many factors that could be involved in drier vaginal tissue and lack of natural lubrication. Some of these factors are:
low levels of estrogen (menopause is the most common reason for this)
lack of arousal during sex (it's important to distinguish between everyday dryness and the ability to lubricate when aroused. These are two different things.)
reduced blood flow to vaginal tissue
sensitivity of vaginal tissue
Let's delve a little deeper into each of these:
Low estrogen causing vaginal dryness
The most common reason for vaginal dryness is estrogen levels declining at menopause. Menopause can occur naturally around the age of 51 (plus or minus 5 years), or it may be induced surgically via a hysterectomy at a younger age.
Up to 50% of women post menopause can experience a condition call vulvovaginal atrophy due to less circulating estrogen. This condition can be debilitating and women who are affected report that their quality of life is negatively impacted by vaginal dryness.
If you're a long way from menopause but you still feel like your vagina is dry, it could still be due to low estrogen levels. These are some common reasons for having lower estrogen levels:
PCOS (polycystic ovary syndrome)
hypothalamic ammenorhea (no ovulation or bleed)
taking the oral contraceptive pill
immediately after a period
perimenopause (women over 40)
In most of the above situations, vaginal moisture should return when your menstrual cycle returns to normal. However if the dryness persists, or if your cycle doesn't become regular and monthly, then please seek help to support your menstrual cycle naturally.
Health conditions causing vaginal dryness
The follow are a few conditions that might contribute to or cause vaginal dryness:
1. Sjogrens syndrome is an autoimmune condition whereby the immune system mistakenly attacks secretory glands in the eyes, skin, mouth, throat and vagina, leading to less moisture.
2. Diabetes is a condition where high levels of glucose circulating in the blood stream damage blood vessels. Blood vessel damage can affect blood supply to tissue in the vagina and reduce lubrication. Vaginal dryness is twice as likely after menopause if you have diabetes.
3. Dermatitis can affect all areas of skin, including the vulva and the vagina. Contact dermatitis can be caused by soaps, lubricants, perfumes, underwear that doesn't breathe.
4. Lichen planus and lichen sclerosus are inflammatory dermatological conditions of the vagina and vulva resulting in itchy bumps, white patches, cracking, and in some cases fusion of the genital skin. These conditions are important to diagnose and treat because they can cause permanent scarring and disfiguring of the vulva and vagina.
Medications contributing to a dry vagina
If you're experiencing vaginal dryness it's a good idea to check if any of the medications you take could be playing a part. The following are some of the most frequently reported:
1. Anti-histamines are medications that some women take on a daily basis to reduce allergic symptoms to pollens, dust and other allergens. Anti-histamines can dry up mucous secretions in your eyes and nose and also in your vagina.
2. Anti-depressants. Women who take SSRI type of antidepressants sometimes report a lack of vaginal lubrication.
3. Medications to suppress estrogen. These medications may be prescribed to you if you have endometriosis or are at risk of estrogen related cancers.
4. Some blood pressure medications can slow the heart rate and reduce blood flow to vaginal tissue, causing dryness and a lack of lubrication.
5. The oral contraceptive pill can cause vaginal dryness, especially if you are taking a low estrogen type of pill.
Lack of arousal during sex
Vaginal dryness and lubrication during arousal are different things. However if you are experiencing both, then sex can be painful and sometimes impossible.
Lack of arousal during sex is a complex topic and their are too many factors to discuss here, such as relationships that are no longer nourishing you anymore, or a lack of foreplay.
If you live your life in 'fight or flight' you may have chronic low energy levels and just be unable to switch off from the day in order to relax and feel sexy.
Limited blood flow to vaginal tissue
If blood flow to the vaginal tissue is compromised, the cells within the vagina aren't nourished or lubricated. Some of the things that cause reduced blood flow are:
dehydration from lack of water, or too much salt or alcohol
health conditions and medications that reduce blood flow such as diabetes and some blood pressure medications (see above).
Dryness caused by irritation and sensitivity in your vagina
Irritation and sensitivity can be caused by:
tampons wick away moisture from vaginal tissue as well as soaking up blood
vaginal products such as soaps, douches, powders, lubricants. Check that they are natural and don't affect the pH of the vagina
underwear that doesn't breathe, including period underwear
What to do about a dry vagina
Grab a hand mirror and check it out. Can you see what looks red or dry? It's a good idea to be familiar with your vagina and vulva so you know what looks and feels normal for you. That way if something seems wrong, you can have a look to see if you can spot the source of the problem.
It's important to get a diagnosis if your vagina is dry to rule out any conditions that may need medical treatment. The first step is to book an appointment with your doctor. Your doctor may then refer you to a gynaecologist, dermatologist or specialist pelvic floor physiotherapist for evaluation of the dryness and to rule out other medical conditions. You may also be referred to a counsellor if the dryness is having an emotional impact on your life.
If low estrogen levels are the culprit, your doctor may prescribe a low dose of estrogen to be applied using a vaginal pessary. This is helpful for post menopause women, however many will seek a natural alternative. If you're a younger women, you may benefit from non hormonal ways of working with your menstrual cycle.
How a naturopath can help with vaginal dryness
When I work with you to help with vaginal dryness we will take a holistic view of your health and determine which of the above factors are likely to be contributing to the dryness.
Here are a just a few examples so that you can get an idea of what an individual treatment might look like:
If you are post menopause we can support your natural estrogen levels, vaginal tissue integrity, and lubrication using diet and herbal medicines (oral and topical).
If you are post menopause and you also have diabetes or lichen sclerosus, then we can work to reduce the damaging effects of these conditions.
If you take antihistamines every day and you have a lot of stress in your life, we will prioritise supporting your immune system to reduce your need for antihistamines; and also work on lifestyle changes to reduce your stress levels.
If you have endometriosis and have been prescribed estrogen blocking medications, we can support endometriosis naturally to reduce the need for medication.
Practical naturopathic tools
When you come to see me in clinic
I almost always recommend herbal medicines to support the underlying cause of your dryness.
I blend up intimate creams using herbs and nutrients specifically for your vagina. Your cream will be very individual and will depend on what you and your vagina can most benefit from, taking into account how sensitive your vaginal tissue may be.
I may recommend dietary changes to include more foods with phytoestrogens, essential fatty acids, vitamins A, E and C for vaginal tissue integrity. You may benefit from taking some of these nutrients in supplement form.
I love to work with individually blended flower essences to assist with the emotional issues that can arise with vaginal dryness.
I may recommend a test to determine how healthy your vaginal microbiome is. Healthy bacteria in your vagina can assist with healthy tissue and protect against vaginal diseases
We will definitely talk about your stress levels and come up with a plan to support you on a day to day basis.
Book an appointment to discuss natural treatments for vaginal dryness, I would absolutely love to support you to feel in control of your intimate health!
10 tips for caring for
the perimenopausal vagina
Hi! I'm Simone Jeffries. I am a naturopath, nutritionist, herbalist and certified wellness coach. I am also a foodie and an advocate for a whole food diet.
I love to support you with hormonal conditions, histamine intolerance and vaginal imbalances.
The information in this blog is from my Bachelor of Health Science degree, experience from working with women in my clinic, and continuing research.
This blog is for information only and not intended to take the place of medical advice. Please seek assistance for any medical concerns.