Vaginal Dryness: Causes, Treatment & Help

Nearly every woman experiences the symptom of vaginal dryness at some point in her life. The causes of this are many and varied. Often, the phenomenon is temporary. However, if vaginal dryness occurs permanently, it represents a severe impairment of the quality of life.

What is vaginal dryness?

A varying degree of moisture in the vagina is largely normal. Only when the vagina feels dry over a long period of time is it called vaginal dryness. Lubrication is the medical term for the moisture that is produced in the vagina during sexual arousal, making it slippery. Responsible for the production of vaginal secretion are the Bartholinian and Schenkerian glands. These glands of the female reproductive organs secrete a fluid during the arousal phase, which is pressed through the vascular walls due to the increased blood flow in the vagina. It consists of a number of different substances, mainly water and various fatty acids. Since the female cycle is subject to hormonal fluctuations, varying degrees of moisture are also largely normal. Only when the vagina feels dry over a longer period of time is it referred to as vaginal dryness.

Causes

Among the causes of vaginal dryness, a distinction must be made between organic findings and psychological reasons. The main physical cause is considered to be the onset of menopause. The hormonal change during menopause causes a decreased production of female sex hormones, including estrogen. Major medical interventions, such as surgery on the uterus, removal of the ovaries or cancer with subsequent chemotherapy, are also possible causes of vaginal dryness. Fungal infections of the vagina and various STDs alter the sensitive vaginal flora and cause it to dry out. Pregnancy, breastfeeding and the use of hormonal contraceptives such as the pill can also cause a lack of lubrication. Mental causes of vaginal dryness include anxiety, stress and difficulties in the partnership. Unpleasant sexual experiences often result in a lack of arousal.

Diseases with this symptom

  • Menopause
  • Endometriosis
  • Sjögren’s syndrome
  • Vaginal fungus
  • Multiple sclerosis
  • Alcohol addiction
  • Diabetes mellitus
  • Hypertension
  • Nicotine addiction

Typical symptoms and signs

  • Lack of natural-moist vaginal flora.
  • Burning in the vagina (vaginal burning)
  • Pain during sexual intercourse of the woman
  • Sexual dysfunction of the woman (frigidity)

Diagnosis and course

Common symptoms of vaginal dryness are itching or burning of the vagina, small cracks in the skin and mild inflammation. The lack of lubrication of the vagina causes pain during sexual intercourse, further decreasing sexual desire. This reduces the release of estrogens, which are responsible for increased blood flow and moistening of the vaginal wall. Hormones also influence the formation of lactic acid and thus ensure the natural, acidic environment of the vaginal flora. A deficiency increases the risk factor for infectious diseases and urinary tract complaints. In the case of prolonged complaints, it is therefore advisable in any case to make an appointment with the gynecologist to clarify the exact cause.

Complications

Vaginal dryness that is not treated increases the risk of developing infections. These infections can affect the vaginal area and also spread to the urinary tract. The vaginal walls become increasingly thinner and develop less and less moisture. The tissue becomes more fragile and bacteria as well as yeast fungi can penetrate and multiply more easily. In addition to the more frequent occurrence of urinary tract and vaginal infections, wounds, tears and injuries in the vaginal area develop more quickly with mechanical irritation. This, along with the lack of hydration, leads to pain during sexual intercourse in women. Problems such as a stronger urge to urinate and increased infections can become chronic. Under treatment with estrogens in tablet or patch form, the development of some cancers may increase.With topically applied estrogens in the vagina, it is possible that cancer of the endometrium may develop. Moist creams made without estrogens also resolve vaginal dryness and are safer to use. These creams do not contribute to an increase in cancer risk. However, disorders are more frequently observed here, with temporary burning, redness and skin irritation due to intolerance reactions.

When should you see a doctor?

Women during and after menopause will experience vaginal dryness, which is part of the healthy aging process for women. However, if it occurs in women of fertile age, it makes sense to consult the doctor about it. Treatment is simple, vaginal creams and gels provide relief. However, they do not solve the underlying problem. Early onset vaginal dryness may have physical causes such as an imbalance of hormones. This must be investigated, because behind it can be quite harmless reasons or serious diseases. The vaginal dryness would be only their first obvious symptom. Visiting a doctor thus contributes to timely detection. A visit to the doctor can also reveal psychological causes of vaginal dryness, which can then be treated by a sexual psychologist. Especially in women, psychological problems often manifest themselves in disorders of sexuality, even if they do not even have anything directly to do with it. Therefore, it is advisable to consult a doctor who is familiar with these complex relationships. If vaginal dryness occurs for the first time during menopause, it may be advisable to inform the gynecologist treating the patient, despite the frequency of this problem. During menopause, many things change and there is nothing wrong with investigating a new observation that has occurred more closely. If vaginal creams and gels do not help to combat vaginal dryness, the doctor can recommend effective alternatives so that a pain-free sex life remains possible.

Treatment and therapy

If estrogen deficiency is the cause of vaginal dryness, the doctor may administer an injection or prescribe hormone-containing tablets. For symptoms due to menopause, hormone treatment has long been common. However, the risk-benefit ratio must be carefully weighed. Alternatively, there are locally acting estrogen preparations in the form of ointments, gels or suppositories. They improve blood circulation and moisten the vagina. The skin becomes thicker and more elastic again. Those who do not want to or are not allowed to take hormone-containing preparations, e.g. after cancer, can switch to a hormone-free preparation. This is usually available without a prescription as a cream or gel. The moisture balance of the vagina is restored for a short time and the vaginal skin stabilizes. The natural colonization of the vaginal flora with beneficial microorganisms is strengthened by lactic acid bacteria, thus restoring the balance. To ensure relaxation during intimate intercourse, the use of lubricants is recommended. They are available as moisturizing gels or suppositories. Lubricants containing oil or grease also have a nourishing effect on the skin. However, if a condom is used for contraception, make sure to use a compatible water-based lubricant.

Outlook and prognosis

Vaginal dryness makes a fulfilling sex life difficult and often causes the woman pain during intercourse. In part, there is a hormonal cause for this. During menopause, a woman’s body adjusts to a time without monthly ovulation and hormone levels change permanently. This can lead to a simultaneous change in sexual desire and vaginal dryness. There may be an improvement when menopause is over and the woman will definitely no longer have periods – but the vaginal dryness may persist. Therefore, it is important to treat it symptomatically during this time. If the woman wants to have sexual intercourse, this works best with lubricant or with a product that keeps the vagina moist. Vaginal dryness can also have psychological reasons outside of menopause. If the woman is afraid of sex or if there are problems in the partnership that affect her feelings for her partner, no psychological sexual arousal takes place and the vagina does not become moist.It is therefore not physically caused vaginal dryness, but rather a symptom of a mental circumstance. If this can be resolved, vaginal dryness is thus usually no longer a problem.

Prevention

In many cases, vaginal dryness can be prevented. Excessive intimate hygiene with soap attacks the natural acid mantle of the skin. Instead, plenty of water and a mild cleansing lotion should be used. Tampons additionally dry out the skin and should accordingly not be changed too frequently. Underwear made of natural fibers provides a better microclimate. Too tight-fitting pants, on the other hand, tend to worsen this.

What you can do yourself

In case of vaginal dryness, the gynecologist should always be consulted first. After this has clarified the cause, various home remedies and measures can be applied to relieve the discomfort. In many cases, it already helps to use pads or menstrual cups instead of tampons. Other factors that irritate the bacterial environment in the vagina should also be avoided. Harmful factors include chlorinated water, perfumed skin care products, and tight pants or underwear made of synthetic fibers. Loose-fitting clothing and underwear made of natural fibers help to stabilize the vaginal environment. In addition, it is important to exercise and use relaxation measures to reduce mental strain caused by nervousness or stress. Regular exercise also promotes blood circulation and thus leads to better moistening of the vagina. Vaginal dryness as a result of allergy or overstimulation can be relieved by a vinegar bath. Aloe vera soothes irritated mucous membranes and provides them with the necessary moisture. A healthy and balanced diet is especially important during menopause. Foods such as soy or flaxseed contain estrogen-like substances that naturally regulate the vaginal environment and thus also reduce vaginal dryness.