While atrophic vaginitis can have many causes, the primary cause is a decrease in estrogen levels — the primary sex hormone in women. Normal estrogen levels are necessary to keep the vagina healthy and stimulate vaginal glands to release fluid. This fluid, in turn, moistens the vagina, facilitates intercourse, and maintains an acidic environment that kills microbes and prevents their overgrowth.
However, when the estrogen in the body decreases, especially after menopause, its supporting effect on the vagina is lost. As a result, vaginal walls, its glands, the supportive tissue, and the skin surrounding the vagina and vulva; undergo atrophic (degenerative) changes. These changes lead to inflammation and dryness of the vagina.
Apart from menopause, the following may cause a drop in estrogen or vaginal atrophy/dryness, in general:
- Certain medications used for diseases like breast cancer, fibroids, infertility
- Hysterectomy — a surgical procedure to remove the womb (uterus) — with ovary removal
- Radiotherapy to treat the pelvic area
- Chemotherapy
- Chemicals in swimming pool or hot tubs
- Anxiety, depression
- The use of certain antidepressant medications
- Smoking
In addition, estrogen levels are lower right after childbirth or while breastfeeding. As a result, some women experience vaginal dryness at these times. Furthermore, some soaps, laundry detergents, lotions, perfumes, or douches may also precipitate vaginal dryness.
Vaginal Dryness Symptoms
Some of the symptoms of vaginal dryness may include:
- Loss of lubrication during sex
- Pain and discomfort during sex
- Light bleeding during or after sex
- Burning and irritation during urination
- Vaginal Itchiness, burning, and irritation during other times
- Mild changes in color, odor and consistency of vaginal discharge
Vaginal Dryness Diagnosis
Your doctor will make the diagnosis based on the history of your condition and presenting symptoms. In addition, they will perform a physical exam to confirm their diagnosis. For example, pale, red, and thin vaginal walls during the pelvic exam signify vaginal dryness.
Furthermore, your doctor may also recommend having your vaginal discharge tested to rule out other possible conditions. They may check your hormone levels to see if you are going through menopause.
Management Of Vaginal Dryness
Once your doctor has diagnosed your condition to be vaginal dryness/atrophy; they may prescribe the following:
- Prescription estrogen. It is available in creams, gels, vaginal rings, vaginal pessary, or tablets. Local estrogen reduces the side effects of oral tablets while simultaneously providing the vaginal walls with maximal benefits. For example, local estrogen reduces vaginal dryness and its associated symptoms. Using local estrogen reduces your risk of urinary tract infections, especially if you already suffer from recurrences of such infections.
- If you also have hot flashes or other symptoms of menopause, your doctor may recommend estrogen in the form of a skin patch or oral pill. Oral pills or skin patches, while delivering enough estrogen to the bloodstream, do not provide adequate estrogen to the dry vagina. For this reason, your doctor may also recommend additional vaginal medications that specifically act on the vagina and reduce vaginal dryness.
Consult your doctor thoroughly about the risks and benefits of estrogen replacement therapy. In addition to medications, many home remedies can also offer relief. These include:
- Using lubricants and moisturizers that moisten the vagina. Their effects can last from hours to days, especially those of vaginal moisturizers
- Using a lubricant right before sex
- Taking time before sex, especially prolonged foreplay, can prove helpful
- Avoiding lotions, perfumes, douches, and scented soaps.
The Outlook for Vaginal Dryness
While seeking help may seem a daunting task, the good news is you can get rid of your vaginal dryness to a large extent. Many medications and other home remedies help ease the symptoms most of the time.
Vaginal Dryness Complications
Even though vaginal dryness is not a serious health concern, it can significantly lower your quality of life in many ways. Some of the possible complications of vaginal dryness include:
- Increases your risk of getting yeast or bacterial infections of the vagina
- Leads to sores or cracks in the walls of your vagina
- May cause painful sex, reducing your desire for sex and affecting your relationship with your partner or spouse
- Makes you more prone to developing urinary tract infections (UTIs)
When To Seek Medical Attention
If you have been experiencing vaginal dryness for quite some time, you must seek medical attention. Some warning signs may include:
- Burning sensation during urination
- Pain and discomfort during intercourse
- Light bleeding during or after intercourse
- Vaginal Itchiness, burning, and irritation that does not go away with lubricant
