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Vaginal Dryness

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Definition

Dryness of the vagina or vaginal dryness can result from reduced secretion of vaginal fluids. When your vagina is dry, it can feel itchy and irritated.

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Causes

  • Reduced estrogen levels in the body
    • Menopause and post menopause
    • Surgical removal of your uterus and/or both ovaries (Total hysterectomy with bilateral salpingo-oopherectomy)
    • Breast-feeding
    • Conditions that cause your ovaries to release reduced amounts of estrogen, such as anorexia, exercise-induced amenorrhea and hypothalamic amenorrhea
  • Drops in estrogen level before and after your menstrual period

  • Chemotherapy

  • Methods of contraception including pills, shots and implants

  • Medications such as tamoxifen (Nolvadex) and raloxifene (Evista)

  • Allergy medications, such as antihistamines.

  • Medications used for ulcer, antidepressants and high blood pressure medications.

  • Sjogren's syndrome - An autoimmune disease associated with dryness of mucous membranes of the mouth, vagina etc.

  • Douching - This process of cleansing your vagina with a liquid preparation, this may disrupt the normal chemical balance in your vagina and cause it to feel dry.

  • Vaginitis - inflammation of vagina

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Implications

This can make daily activities uncomfortable and sexual intercourse less pleasurable. In fact, it is the primary cause of painful sex (dyspareunia). Vaginal dryness is a common problem that affects women of all ages at some point in their lives.

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Treatment

  • Estrogen replacement therapy.
    • Vaginal estrogen cream (Premarin, Estrace) can be inserted into your vagina with an applicator 2 or 3 times a week.
    • Skin (transdermal) patches containing estrogen (Alora, Climara) can be applied to your skin and worn from several days to a week at a time.
    • Vaginal estrogen ring (Estring) is a soft, plastic ring which is inserted into the upper part of your vagina. The ring releases estrogen slowly over a period of 90 days.
    • Vaginal estrogen tablets (Vagifem) can be placed in the vagina with a disposable applicator, on a daily basis for the first 2 weeks and then twice a week.
    • Oral hormone supplements in combination form (estrogen plus progesterone) on a daily basis are effective.
  • Lubricants and moisturizers
    • Water-based lubricants such as Astroglide, Lubrin, K-Y Jelly work to lubricate the vagina for several hours. Insert the lubricant into your vagina and apply it to your partner's penis before intercourse.
    • Vaginal moisturizers like Replens, K-Y Long Lasting act on the vaginal tissue and may decrease dryness. This has to be done once a day on a daily basis. Moisturizers generally have a low pH that maintains the acidic environment in the vagina and may decrease infections.
  • Allow your body to be adequately aroused and your vagina to be sufficiently lubricated before having sexual intercourse. Have sexual intercourse on a regular basis to help promote better vaginal lubrication.
  • Make sure that you drink enough water.
  • Avoid the use of:
    • Vinegar
    • Douches.
    • Yogurt or cultures of lactobacilli.
    • Hand lotions.
    • Soaps.
    • Bubble baths.
    • Bath oils.
    • Oil-based products, such as petroleum jelly and baby oil.
  • Dietary supplements
    • Vitamin E provides lubrication and relieves itching and irritation.
    • Isoflavones are plant estrogens and are compounds found in soybeans, soy products like tofu, soy milk and red clover. These substances can produce a weak estrogen-like effect.
    • Black cohosh, also called Cimicifuga racemosa, is a plant that is purported to reduce some symptoms of menopause, including vaginal dryness.

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Caution

Do not use black cohosh for longer than 6 months, and do not use it in combination with estrogen replacement therapy or antihypertensive medications.

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Vaginal Dryness