Berman Sexual Health

Vaginal dryness is much more than a troublesome nuisance. But given the time constraints of office visits, many patients are understandably reluctant to discuss it, spending their limited time on more pressing questions. However, treating the emotional and physical discomfort that dryness can impose on a woman's life is an opportunity to greatly improve her quality of life. For that reason, it is important to fully appreciate and communicate the potential for good that can come as a result of the right diagnosis and effective treatment for this correctable predicament.

Vaginal dryness ranks among the 10 most common problems occurring during menopause. According to a recent Gallup study,(1) as many as 13.9 million women 18 and older have experienced vaginal dryness. By 2014, this number is expected to increase to over 15 million as Baby Boomers continue to age. Over a quarter (26 percent) of women 50 and older experience irritating, recurring vaginal dryness, and 12 percent of women under 40 complain of it. Among those complaining of vaginal dryness, nearly nine out of 10 women (87 percent) describe it as at least moderately bothersome, with 51 percent finding it very bothersome.(2)

Vaginal dehydration, brought on by chemical or physical changes in the body can lead to symptoms that include painful sexual intercourse, itching, unattractive odor, and discomfort in even simple activities such as walking. If left untreated over time, this condition can exacerbate, resulting in much larger problems.

{mosbanner:id=1:right:0}Bacterial vaginosis (BV), often mistaken for a yeast infection, is one of the more common and serious side effects, stemming from an imbalance of the pH level or alkalinity in the vagina, triggered by chronic dryness or in combination with other causes.(3) BV is known to increase the risk of sexually transmitted infections, including AIDS and is an important risk factor for obstetric complications such as prematurity, low birth weight, post-partum endometritis and miscarriage.(4) Table 1 (See Appendix) Yeast infections and abnormal vaginal discharge are also common in patients with recurrent vaginal dryness.(5)

Women need to be aware of the ways to treat vaginal dryness so that they are comfortable and can prevent potentially unhealthy conditions from developing. The best way to overcome vaginal dryness is to understand its origins and keep it under control, taking a holistic approach to alleviate recurrences.

What causes vaginal dryness?

A list of factors that contribute to vaginal dryness are shown in Table 2 (See Appendix). When the blood vessels that bring nutrients and oxygen to the vagina become constricted due to a number of possible circumstances, dryness ensues. These nutrients help maintain vaginal elasticity and health, ensuring that sufficient amounts of mucus and vaginal secretions maintain vaginal flexibility and elasticity.

With a dry condition, not only is sexual intercourse uncomfortable and even painful, but also the vaginal environment becomes more prone to bacterial and viral infections that may then be passed on to a partner. Frequent yeast infections may also occur, and patients often complain of off-color or off-odor vaginal discharge accompanied by itching and burning sensations. (6)

Changes in vaginal moisture can occur in response to hormonal cycles, for example during breastfeeding, menopause, or while on low-dose oral contraceptives. It can also occur in response to douching, pelvic radiation, prolonged use of tampons, advanced endometriosis and a variety of medications and other causes.(7)

Some cancer treatment medications, such as tamoxifen (Nolvadex) and - aromatase inhibitors such as Arimidex, designed to interfere with the aromatization of androgens to estrogens, may produce vaginal dryness. (8) Allergy medications and antihistamines can also dry out the body's mucous membranes, causing dryness in the vaginal wall. Certain ulcer, antidepressant and high blood pressure medications can contribute to vaginal dryness.

Estrogen causes the vagina to thicken and moisten. When estrogen levels become depleted, hormone therapy (HT) with estrogen is the most-often prescribed treatment for vaginal dryness; but it may also slightly increase a woman's risk for breast and/or uterine cancer. (9) Understandably, many women are opting to try other means of relief.