Vaginal Dryness and Pain
Vaginal dryness is a common symptom of menopause and it affects one in three of menopausal women. It ranks in the top ten common problems occurring during menopause. However, vaginal dryness can occur at any age. The lack of vaginal moisture can have a greatly impact a woman’s sex life, self-confidence, and relationships. Decrease vaginal moisture can also make women more prone to vaginal yeast, bacterial and viral infections.

Vaginal Dryness and Estrogen Production
Estrogens are primarily made by the ovaries but are also produced by the cervix (uterus) and then released into the vaginal tissues. Before menopause, the vagina and skin and tissues around the vagina are kept supple, thick and moist by fluids and mucus released by cervical glands under the influence of estrogen. Estrogen also stimulates vaginal cells to produce glycogen. Glycogen is a substance that supports the growth of beneficial bacteria, which protect the vagina from infections.

Most women begin menopause between the ages of 45 and 55, but it can occur earlier or later in life. The ovaries make less estrogen after menopause. Decreased estrogen production can lead to thinning of the tissues around your vagina and a reduction in the number of glands that make mucus. The hormonal changes that occur during the menopause make the vagina shorter, less elastic, drier and result in the loss of fat tissue from around the genital area. Thinning and weakening of tissues around the opening of the bladder can occur leading to symptoms of urgency, frequency, recurrent urinary infections, and stress incontinence. These changes can take months or years to develop and vary from woman to woman. Atrophic vaginitis is the medical term to describe this condition when these vaginal changes produce bothersome symptoms that warrant medical intervention.

In addition to the vaginal changes, women may experience other changes during the menopausal transition. Hot flashes, night sweats, mood changes, fatigue, urinary tract infections, urinary incontinence, acne, memory problems, thinning hair, skin discoloration, and unwanted hair growth may also occur.

What causes vaginal dryness?
The best way to combat vaginal dryness is to understand its causes and treatment options. The vaginal wall is kept moist and thick under the influence of estrogen. Estrogen levels drop during menopause, which may lead to vaginal thinning, unpleasant order, bladder problems, painful intercourse, discomfort during activities, and decrease vaginal moisture and elasticity. Other causes the can lead to decreased estrogen production include childbirth, breastfeeding, radiation, chemotherapy, anti-estrogen medications and the surgical removal of ovaries. Lack of or inadequate foreplay before sex, chronic sex, prolonged tampon use, endometriosis, and Sjogrens Syndrome. Cold and allergy medications, ulcer drugs, birth control pills, anti-depressants, anti-hypertensive medications can lead to decreased vaginal moisture. Avoid using douches, bubble baths, scented soaps, fragrances and lotions around the sensitive vaginal area, which can worsen dryness.

How is vaginal dryness treated?
The most common treatment for vaginal dryness due to low estrogen levels is topical estrogen therapy. You can get relief without taking large amounts of estrogen orally. Locally applied bio-identical estrogens are considered a much safer option than oral hormone therapy since most of them allow only minimal amounts of estrogen to enter into your circulation. They deliver estrogen to the vagina and surrounding tissues that increase tissue thickness, elasticity, and moisture.

Vaginal estrogen cream treatment is used every day for about two weeks, and then twice a week for three additional months. Symptoms should improve after three weeks of treatment but repeated courses of treatment are often necessary.

Natural lubricants such as vitamin E suppositories and coconut oil can be used to improve vaginal dryness and decrease dryness during sexual intercourse. Vaginal dilators may also be helpful to enhance vaginal flexibility and relax vaginal muscles. Women should consult a doctor to decide which treatment options are best for them.
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