vaginal dryness

Vaginal Dryness – Atrophic Vaginitis

Definition:  Vaginal dryness (Atrophic vaginitis) is a common problem in women during menopause and beyond; Although insufficient lubrication of the vagina can occur at any age.

 Vaginal dryness is a hallmark of vaginal atrophy, i.e. the thinning and inflammation of the vaginal walls due to the decline in the level of estrogen. Vaginal dryness may be accompanied by itching and burning around the vaginal opening and in the lower third of the vagina, which can make sexual encounters uncomfortable.

When you’re sexually aroused, more blood flows into your pelvic organs, making more fluid for the vagina, but hormonal changes during menopause, childbirth, and breastfeeding can disrupt this process.


Vaginal dryness can be accompanied by the following symptoms and signs:

  • itching
  • burning
  • ulceration
  • Pain or light bleeding with sex
  • Frequent urination or urgency to urinate

When should you consult a doctor?

Atrophic vaginitis affects many women, although they don’t often bring up the topic with their doctor. If vaginal dryness is affecting your lifestyle, especially your sex life and your relationship with your partner, consider making an appointment with your doctor.

Living with vaginal dryness that causes discomfort doesn’t have to be a part of getting older.

the reasons

There is a thin layer of thin fluid covering the walls of the vagina, and most of this moist secretion flows through the walls of the blood vessels that surround the vagina; The hormonal changes during the menstrual cycle and advancing age affect the quantity and density of these secretions.

 There are many conditions that contribute to vaginal dryness, including:

1- Decreased estrogen levels

Low estrogen levels are the main cause of vaginal dryness. Estrogen – the female hormone – helps maintain healthy vaginal tissue by maintaining the natural hydration of the vagina, tissue elasticity, and pH. These factors create a natural defense against infections of the vagina and urinary tract, but when estrogen levels decrease and therefore the natural defense decreases, the vaginal lining becomes thicker, less elastic, and weaker.

Reasons for low estrogen levels include:

  • menopause or postmenopausal
  • Birth
  • Breast feeding
  • The effect of cancer treatment on the ovaries, including radiation, hormonal and chemotherapy.
  • Surgical removal of the ovaries
  • immune disorders
  • cigarette smoking                                                  

2- Medicines

Allergy and cold medicines, as well as some antidepressants, can reduce moisture in many parts of the body, including the vagina. Anti-estrogen medications, such as those used to treat breast cancer, may also cause vaginal dryness.

3- Sjogren’s syndrome

This is an autoimmune disease in which the immune system attacks healthy tissues. In addition to the symptoms of dry eyes and mouth, Sjogren’s syndrome can also cause atrophic vaginitis.

4- Washing the vagina

Cleaning the vagina with a liquid product (vaginal douche) disrupts the natural chemical balance in the vagina and can cause vaginitis, which can cause vaginal dryness and irritation.

Getting ready for the doctor’s appointment

If your doctor is usually a family doctor or a general practitioner, he or she may refer you to a specialist doctor (gynecologist) for evaluation.

Here’s some information to help you get ready for your appointment, and what to expect from your doctor.

What can you do

  • You need to be aware of any requirements in advance of the appointment. At the time you make the appointment, be sure to ask questions about whether anything needs to be done in advance to prepare for common diagnostic tests.
  • Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason you made the appointment.
  • Make a list of your key medical information, including any other conditions you’re being treated for, the names of any medications, and vitamins or supplements you’re taking.
  • Think of questions to ask your doctor and write them down. Take a long notepad and a pen to jot down the information while the doctor answers your questions.

What can you expect from your doctor?

Your doctor is likely to ask you several questions. Being prepared to answer these questions frees up time to review any points you would like to spend more time studying. Your doctor may ask you:

  • What are the symptoms you are experiencing in the vagina?
  • How long have you had these symptoms?
  • Is your period still regular?
  • How distressing are these symptoms for you?
  • Are you sexually active?
  • Does the condition restrict your sexual activity?
  • Do you use scented soap or bubble bath?
  • Do you wash your vagina or use feminine cleaning spray?
  • What medications or supplements and vitamins do you take?
  • Have you tried over-the-counter moisturizers or lubricants?

Tests and Diagnosis

Diagnosing vaginal dryness may include:

  • Pelvic examination. Your doctor visually examines the external genitalia, vagina and cervix, and also examines the vagina to palpate the pelvic organs for symptoms of disease.
  • door test. Your doctor collects a sample of cervical cells for examination under a microscope. Your doctor may also take a sample of your vaginal secretions to check for signs of vaginitis or to confirm changes related to estrogen deficiency.
  • urine test. You provide a urine sample to be analyzed for the presence of diseases in the urinary system, if there are associated symptoms in the urinary system.

Treatments and medicines

1- Vaginal estrogen therapy

As a rule, treating vaginal dryness is more productive with topical (vaginal) estrogen rather than estrogen pills. Estrogen that is applied to the vagina may cause the estrogen to reach the blood, but in less quantity. Also, vaginal estrogen does not lower testosterone levels — which is important for healthy sexual function — in the same way as estrogen pills.

Vaginal estrogen therapy comes in many forms:

  • Vaginal estrogen cream. You insert this cream directly into the vagina with a medical device, usually at bedtime. Your doc will tell you how much cream to use and how often, usually every day for the first few weeks and then two to three times a week after that.
  • Vaginal estrogen ring. A soft, flexible ring that is inserted into the upper part of the vagina either by you or your doctor. The ring releases a steady dose of estrogen from its position and must be replaced every three months.
  • Vaginal estrogen tablet. You place a vaginal estrogen tablet into the vagina using a medical device. Your doc will tell you how often to inject the tablet, for example every day for the first two weeks, and then twice weekly thereafter.

If vaginal dryness is accompanied by other symptoms of menopause, such as moderate to severe hot flashes, your doctor may suggest estrogen tablets, patches, or gels, or he may suggest a higher-dose estrogen ring with a progestin. Talk to your doctor to decide if hormone therapy is a good option, and which type is best for you.

2- Lifestyle and home remedies

Use a lubricant or moisturizer

To treat vaginal dryness, try an over-the-counter product:

  • Lubricants: Water-based lubricants moisturize the vagina for several hours. Apply the lubricant to the vaginal opening or to your partner’s penis before intercourse.
  • Moisturizers: These products mimic the natural moisture in the vagina and relieve dryness for up to three days after one use. Use these products as an ongoing protection from irritation caused by vaginal dryness.

Take care of your sexual needs

Occasional vaginal dryness during intercourse may mean you haven’t been sufficiently aroused. Make time for excitement with your partner and allow your body to get enough excitement and hydration. It may be helpful to talk to your partner about things that you feel are good. Also, having regular sex may help promote better vaginal lubrication.

Avoid certain products

Although you may be willing to try anything to ease the discomfort, avoid using the following products to treat it as they may cause vaginal dryness.

  • Vinegar, yogurt, or other rinses
  • hand wash products
  • soap
  • bubble baths