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Options in treating vaginal dryness

September is Menopause Awareness Month. There are an estimated 64 million postmenopausal women in the United States (US), and as many as 32 million women may suffer from symptoms including pain during sexual intercourse, vaginal dryness, and vaginal irritation. This number is increasing as approximately 6000 women enter menopause each day in the US. I have worked with thousands of menopausal women for the past 20 years and a good majority of them have confided in me about their discomfort and how it affects their intimate relationships.

Let's first take a quick look at the root cause of the problem in menopausal women. During the childbearing years, a thin layer of clear fluid covers the walls of the vagina. This thin layer keeps the lining of your vagina elastic, thick and healthy. As you approach menopause, there is usually a drop in your estrogen (female hormone) level which reduces the amount of lubrication available. This can lead to vaginal dryness and vaginal atrophy as well as dryness of the external female genitals (vulva). Vaginal dryness may cause fragile vulvovaginal tissues. The tissues may then become more susceptible to irritation, pain during intercourse or dyspareunia (dis-puh-ROO-nee-uh) and sometimes bleeding which is the result of injury and tearing of the vaginal tissue and vulva. Sometimes, even women who are not sexually active are bothered by vaginal dryness and the irritation that may accompany it.

In addition to natural menopause, there may be other factors causing vaginal dryness such as:

  • Chemotherapy and radiation for cancer treatment

  • Certain diseases such as diabetes and Sjogren’s syndrome

  • Some cold and allergy medicines can dry up mucus leading to vaginal dryness

  • Chemical irritants, perfumes, and dyes in soaps, feminine hygiene products

  • Swimming in the pool due to the chlorine used to keep the water clean

  • Anxiety and stress can interfere with your libido or sexual desire and may lead to vaginal dryness

  • Smoking

  • Childbirth

  • Breastfeeding

  • Surgical menopause and removal of ovaries (oophorectomy)