Side Effect: Vaginal Dryness

What is Vaginal Dryness?

Vaginal dryness occurs when the vaginal tissue changes and does not have enough natural lubrication. This can affect pre- and postmenopausal women at any age. This is a common side effect of women being treated with hormonal therapies.

What does Vaginal Dryness look like?

Vaginal dryness often causes discomfort, itching, burning, and pain. These symptoms can happen during normal daily activities such as sitting, standing, playing sports, or exercising. Vaginal dryness can also make sexual activity painful. This can lead to a lower desire to have sex. Dry vaginal tissues can also increase the risk of vaginal infections if not treated.

Who gets Vaginal Dryness?

Estrogen is a hormone that helps maintain healthy vaginal tissue and lubrication. When estrogen is low, the vaginal tissue and lubrication changes, leading to vaginal dryness. Causes of low estrogen include:

• Hormone changes in postmenopausal women
• Surgical removal of the ovaries
• Anti-estrogen medications (tamoxifen, anastrozole (Arimidex®), letrozole (Femara®), exemestane (Aromasin®))
• Treatment with leuprolide (Lupron®) or goserelin (Zoladex®)

Other causes of vaginal dryness include:

• Dehydration
• Low blood flow to the vagina
• Stress and anxiety
• Chemotherapy
• Radiation to the pelvic area

How to prevent Vaginal Dryness

It is important to maintain good vaginal hygiene to prevent dryness. Avoid harsh soaps and douching as these can irritate the vaginal tissue. Before using to ensure it is safe, discuss with your doctor about using a vaginal moisturizer during daily activities and lubricants during sexual activity to prevent friction and discomfort.

How to treat Vaginal Dryness

The main treatments of vaginal dryness are non-hormonal, vaginal-directed therapies. These non-hormonal therapies do not change the vaginal tissue, but they can lessen symptoms by providing moisture and lubrication.

Lubricants can be water-based, silicon-based, glycerin-based or a combination of these. Vaginal moisturizers are helpful to replace normal vaginal secretions. Lubricants can be used during sexual activity to reduce friction and decrease irritation. Another therapy is hyaluronic acid vaginal gel. Hyaluronic acid lessens vaginal dryness by releasing water into the tissues.

Hormonal vaginal directed therapies may also be used. These products can help restore vaginal moisture and improve tissue elasticity. Types of hormonal vaginal therapies include estradiol-releasing intravaginal tablets, low-dose estrogen vaginal inserts, estrogen-based vaginal creams, and estradiol-releasing vaginal rings, vaginal testosterone cream, and vaginal dehydroepiandrosterone (DHEA). It is important to talk to your doctor before starting any vaginal therapies. In some cases, oral estrogen replacement can be used. Talk to your doctor before starting any oral hormone replacement medications as they may increase the risk of blood clots in certain individuals.

In women with pain from sexual activity, seeing a pelvic floor physical therapist (PT) can be helpful. A pelvic floor PT can assess the pain and provide you with ways to decrease pain during sexual activity.