Vaginal dryness is common when going through hormonal changes during menopause. Good news is, there are ways to tackle this symptom and show your vagina and vulva some extra love during this time.
What is vaginal dryness?
During perimenopause, menopause and post-menopause, when your oestrogen levels are declining, your vagina, the inner part of the female genitals, and vulva, the outer part, undergo changes. This can lead to symptoms such as dryness and more. This is called vaginal dryness, also known as vulvovaginal atrophy. The latter could be seen as a more inclusive term because the array of changes are more than just dryness in the vagina.
The hormone oestrogen affects your whole body, including your vagina and vulva. When oestrogen levels decrease, the vaginal cells shrink. This leads to the vagina losing elasticity and the vaginal walls secreting less moisture. Why? Oestrogen is essential for keeping the vaginal walls moisturised, lubricated and elastic. It keeps the vulva plump. When oestrogen decreased the vaginal tissue can also become dry, which can make it painful to have sex.
What are the symptoms of vaginal dryness?
Your vagina and vulva may feel dry, irritated, and itchy. You may feel a burning sensation. Sitting down is uncomfortable. You may feel irritation as your underwear scratches against your lady parts when you’re walking, jogging, doing yoga or exercising. Sex hurts. These are all possible symptoms of vaginal dryness, but they vary from woman to woman.
Some women don’t get itchy at all and instead have urinary symptoms including leakage and incontinence. A urinary tract infection that keeps coming back could also be a sign of vaginal dryness. While these symptoms may not be fun, vaginal dryness is natural and normal during menopause. Around one in three women going through menopause experience it as some point. It affects up even more women in post-menopause - up to forty percent.
What causes vaginal dryness symptoms?
Falling oestrogen levels are usually the most common cause of vaginal dryness during menopause. But there are other factors that can also affect the severity of symptoms, which you can do something about. They include:
Dehydration - drinking enough water is important for your vagina because it helps it stay lubricated. The recommended intake for women is 2.7 litres per day.
Too much stress - high stress levels and anxiety have been shown to impact your sex drive and lubrication. Make time for more bubble baths, sauna, exercise, or cold water bathing. Also check out Olivia’s app for tools and tips for less stress.
Not enough foreplay - foreplay prepares your mind and body for sex. During menopause it may take longer to get aroused and for lubrication to kick in. Therefore this is a time when foreplay is especially important. Studies have shown not enough foreplay can cause vaginal dryness in both pre-and postmenopausal women. Talk to your partner about your needs. Experiment with new ways to extend the moments leading up to intercourse.
Some medications - certain medications and some antidepressants can dry out vaginal tissue.
Sjögren syndrome - an autoimmune disorder that stops cells from producing moisture in the body can affect your vulvovaginal area too.
When do vaginal dryness symptoms show up? Do they go away?
When vaginal dryness symptoms start varies. For some, it starts during perimenopause along with other symptoms such as hot flashes or night sweats. For others, it can start in post-menopause long after other symptoms have faded. One thing is the same, although symptoms like hot flashes tend to improve over time, vaginal dryness doesn’t. There are however both hormonal and non-hormonal treatment options that can make things easier for you. A healthcare professional can help you by giving you a diagnosis after hearing you describe your symptoms.
What helps with vaginal dryness? Here's what you can do
Reflect on your daily hygiene routine. Are you using scented feminine products, soap or a douche to clean up down there? If so, those should be the first to go. Feminine hygiene products are a big no-go. You would think they make your vaginal area nice and clean, right? Your vagina is smarter than that. It’s self-cleaning.
Let your vagina clean itself. Feminine hygiene products can cause irritation, burning and discomfort because they may disrupt the natural PH level in your vagina. A vagina’s natural PH level is about 3,8-4,5. Later in life it rises closer to 5. It is acidic, and gets slightly mor alkaline with age. Your vagina welcomes and has many healthy bacteria. The acidity protects against harmful bacteria.
No no’s for vaginal health:
Scented and unscented soaps - certain soaps and lotions may smell good but will do more harm than good. Your vagina and vulva are sensitive areas and need special care. You can clean the vulva as it gets exposed to more dirt but you need to use specific products that are kind to it, not regular soaps.
Washing the inside of your vagina - even rinsing your vagina with water is typically not recommended. Washing the outside with warm water is okay.
Douches - they can cause damage to your vaginal flora and increase the risk for bacterial infection and other issues.
Simple & effective tips to help with vaginal dryness
Choose underwear wisely. Natural fabrics like cotton are kind towards your vagina and vulva. It helps your vagina breathe and absorb moisture properly. Synthetic materials such as nylon and spandex don’t do the same trick.
Lubricate. Everyone is different - one lubricant may work for one person and may not work for another. There are pro’s and con’s whether you choose water-based, oil-based or silicon-based lubricants. Some ingredients to avoid are glycerin or petroleum.
Moisturise. Just like you moisturise your face and body, the vaginal cells can also be replenished with a good vaginal moisturising cream. While lubrication is used for short-term relief during intercourse by lessening friction and making your vagina more slippery, you can use a vaginal moisturiser daily to rehydrate the dry inner lining of the vagina.
Add phytoestrogens to your diet. Phytoestrogen are naturally occurring compounds found in plants. They are a xenoestrogen, meaning they mimic oestrogen. Your body may respond to them as if it was your own natural oestrogen, but with a weaker effect. However, it is not certain that the body always recognises phytoestrogens and more research is still needed. Flax seed and soybeans are the foods that contain the most phytoestrogens.
Have more sex. Research suggests regular intercourse or masturbation can help slow down vaginal dryness because it increases blood flow to the vagina, keeping it elastic for longer.
Talk to others and read about vaginal dryness. It can also help to talk to others about your experiences. You are not alone with any new feelings, thoughts and questions that may come when experiencing vaginal dryness. Reading books can also be a way to get guidance, support and tips.
3 books tips on vaginal dryness:
Medical treatment options such as Hormonal Replacement Therapy can also help with vaginal dryness. These treatments replace the oestrogen your body is no longer making. With local oestrogen, you can apply the hormone directly to your vagina with creams or ingest them orally. Consult with your doctor to talk about the possibilities and risks in order to find the best treatment for you.
To learn more about how to take care of your vaginal health in the best way, check out the Olivia app.
Abraham C. (2020). Experiencing vaginal dryness? Here’s what you need to know. acog.org/womens-health/experts-and-stories/the-latest/experiencing-vaginal-dryness-heres-what-you-need-to-know
Bosekey E. et al. (2001). Origins of vaginal acidity: high D/L lactate ratio is consistent with bacteria being the primary source https://pubmed.ncbi.nlm.nih.gov/11527880/
Goncharenko V. (2019). Vaginal dryness: individual patient profiles, risks and mitigating measures. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459457/
Gordon B. How much water do you need. Academy of Nutrition and Dietetics. https://www.eatright.org/food/nutrition/healthy-eating/how-much-water-do-you-need.
Jelinsky S. et al. (2008). Molecular analysis of the vaginal response to estrogens in the ovariectomized rat and postmenopausal woman. https://bmcmedgenomics.biomedcentral.com/articles/10.1186/1755-8794-1-27
Nelson H. et al. (2005). Management of Menopause-Related Symptoms: Summary. https://www.ncbi.nlm.nih.gov/books/NBK11956
Office on Women's Health. (2019). https://www.womenshealth.gov/a-z-topics/douching
Panda S. et al. (2014). Vaginal pH: A marker for menopause. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955044/
Vaginal dryness. (2018). menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf