One of the things a woman most hates to ask her gynecologist about is vaginal dryness. It can affect women of any age, but usually is concurrent with menopause or later. It can cause itching, swelling and discomfort, make intercourse painful and sometimes impossible.
It can result from medications (allergy and cold medications, chemotherapy, radiation or anti-estrogen meds taken to treat fibroid tumors), Sjogrenís syndrome (an autoimmune disorder in which the glands that produce fluids are destroyed) or douching. For some people sensitive to chlorine, swimming pools and Jacuzzis can sensitize and/or dry the vagina. Childbirth and breastfeeding also affect estrogen levels and might temporarily reduce lubrication and make the vaginal walls more fragile. Lack of sufficient foreplay prior to sex can also be a cause. But most often, vaginal dryness is caused by the dropping estrogen levels that accompany menopause.
When estrogen levels drop, the vaginal walls begin to thin. This can make intercourse painful as delicate tissue tears. If you are on hormone replacement therapy you may not have this problem, but otherwise itís a somewhat unavoidable condition of aging. The good news is there are ways to remedy it.
Hormone replacement therapy (HRT) is the most permanent way to treat vaginal dryness. Estrogen combined with progesterone can solve this problem quickly. However, with HRT, the hormones affect the entire body for better or for worse. There are concerns about the relationship between HRT and cancer risk, increased blood clotting, strokes, etc. These risks may outweigh the benefits.
Estrogen and progesterone are also available as creams that can be applied topically to your skin. However, they carry the same risks and benefits as oral hormone therapy.
A way to reduce those risks is to confine the estrogen to the specific area in the vagina that needs help. An estradiol ring can be placed in the vagina for 90 days at a time and continuously delivers low-dose estrogen. In this case, very little estrogen gets into the rest of the body. There is also a tablet that you can insert into for two weeks daily then just twice a week thereafter. Most gynecologists believe these to be two safe and effective ways to resolve vaginal dryness.
Phytoestrogens: Flax Seed, Red Clover, Soy, Black Cohosh
Phytoestrogens are substances found in plants like red clover, soy and flax seed, among others. When ingested, they mimic estrogen in our bodies and can act as a natural estrogen replacement. They can have all the same (positive or negative) effects of estrogen in the body including reducing or eliminating vaginal dryness. The downside of this supplementation is that you have no way of knowing how much extra estrogen effect you are creating in your body. While research seems to indicate a protective effect of phytoestrogens for breast cancer, it may have other adverse effects.
Black cohosh, another phytoestrogen, is a powerful herbal used for hundreds of years as a remedy for "womenís problems." Herbal preparations made from its roots are used to treat symptoms of menopause such as hot flashes, night sweats, vaginal dryness, sleep disturbances and mood swings. High doses of black cohosh may lead to certain side effects, such as dizziness, diarrhea, joint pain, nausea, headaches, slow heart rate, weight gain and vomiting. Used in excess it can cause liver damage. Do not use black cohosh if you are pregnant or nursing.
Vitamin E oil and vitamin E suppositories inserted into the vagina can have a substantial effect in helping to soften and strengthen the vaginal wall. Use daily for about two weeks then several times a week to retain the positive effects. An antioxidant, vitamin E also helps to protect your body from environmental free radicals and maintain the immune system.
A November 2008 article in the "European Review of Medical and Pharmacological Sciences" studied the value of vaginal suppositories in managing vaginal atrophy. The authors assessed the effects of intravaginal vitamin E, in addition to other suppositories, as compared to local estrogen replacement therapy. The results of their study demonstrated that natural suppositories of vitamin E produced no adverse side effects, significantly improved symptoms of vaginal atrophy and increased vaginal moisture. There is no evidence that vitamin E increases estrogen levels in the body.
Other non-hormonal options that may improve vaginal dryness include vaginal moisturizers and lubricants. These are available over-the-counter, and can be used either on a daily basis or with sexual activity. Using them regularly can improve vaginal dryness. Your skin may be sensitive to lubricants like K-Y jelly. You may have to look in health food stores or on the Internet for products that are specific for sensitive skin or are hypoallergenic. Products with aloe, a significant moisturizing and natural healing agent are particularly helpful if you have had tearing or inflammation of the vaginal wall.
Calendula, a marigold-type plant has anti-inflammatory and anti-infective properties as well as moisturizing properties. It is widely used as an additive to cosmetic skin creams and may stimulate the production of collagen which may help to support atrophied vaginal tissue. It is also thought to alleviate the itching which may come with vaginal atrophy and dryness associated with menopause. During menopause, the lack of lubrication may predispose the vaginal area to infection; calendula cream may help prevent this problem.
You can find many studies regarding the use of hormone replacement therapy on the Internet and speak with your doctor about its feasibility for your specific condition. The other options listed above are easy to obtain and low in risk. Vaginal dryness is a curable condition! FP
Diane York is a freelance writer on the topics of health, lifestyle and relationships. She has a masterís degree in rehabilitation counseling, is a licensed rehabilitation counselor and her book, "It Ainít you Babe, a Womanís Guide to Surviving Infidelity and Divorce," is available on Amazon.com.