Vaginal Dryness/Vaginal Atrophy: The Secret We Share

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When I ask women in my clinical practice if they are experiencing vaginal dryness many women will answer by saying they are not sexually active -- to which I reply, a woman needn’t be sexually active to experience vaginal dryness (and it needs treatment!). They think again and many realize they are experiencing vaginal dryness. When I ask women in my clinical practice if they are sexually active, they tell me that sex has become too painful due to vaginal dryness usually with the onset of menopause.

These women may have stopped having sex if they in relationships, and never spoke about it again to friends, partners, husbands, or their doctors until I started the conversation. For the mighty few who dare to mention to their doctors that they are having vaginal dryness or that sex is painful, they are often told it is in their head or that they are not communicating well enough with their partners/husbands. That does damage but is not nearly as damaging as the many inappropriate treatments they are given by doctors like lidocaine gel (a numbing agent) or cortisone (a thinning agent which will do more damage). Many women try their own home remedies like Vaseline (although they may as well put gasoline on the sensitive vaginal tissues!)

Keeping mum on such a sensitive and important women’s health issue is problematic. It can shut down a sex life and could lead to divorce. Some women who have had vaginal dryness for a number of years will present with prolapse which means their bladder or uterus has fallen down often right outside of the vaginal opening.

Shutting down a sex life and/or ending up with a prolapse because the vaginal tissues have lost their elasticity due to lack of moisture of the vaginal tissues may lead to a number of health and relationship issues. A prolapse may result in incomplete bladder emptying and lead to urinary tract infections. Vaginal prolapse may be painful and impact a woman’s ability to exercise or work or engage in intimate relationships.

When a woman’s sex life ends due to vaginal dryness or prolapse, her health and relationship may suffer.  Sex is good for sleep, mood, stress reduction, general well-being, and relationships. Her partner may become angry, frustrated and even suspect she is having sex outside of the relationship. The relationship suffers.

Vaginal dryness may progress to vaginal atrophy; a condition marked by the following symptoms:

  • Vaginal dryness
  • Vaginal burning
  • Vaginal discharge
  • Genital itching
  • Burning with urination
  • Urgency with urination
  • More urinary tract infections
  • Urinary incontinence
  • Light bleeding after intercourse
  • Discomfort with intercourse
  • Decreased vaginal lubrication during sexual activity
  • Shortening and tightening of the vaginal canal

When women see a small amount of bleeding after sex or begin to get urinary tract infections, they will become frightened because they think the blood may be a sign of cancer or they may associate the urinary tract infection with sex.  Any or all of the symptoms of vaginal atrophy are the result of a decrease in estrogen, the hormone regulator of the urogenital tract and the vagina, which helps to maintain the ph balance, moisture, and health.

There are personal moisturizers for the vagina in the form of an ovule or a gel which help to heal vaginal tissues and keep them youthful. Using hormone-free personal moisturizers may prevent the progression to Vaginal Atrophy. Hormone-free personal moisturizers are a great option for women who have vaginal dryness as a result of surgical menopause or breast cancer treatments. Low dose localized estrogen in the form of a tablet, cream or ring is the treatment for vaginal atrophy. It is extremely safe and side effect free. It is also important to know that unlike the hot flashes and night sweats of menopause, vaginal dryness does not go away and therefore treatment is lifelong. Treatment takes two to three months to optimize, so be patient.  If you stop your treatment, your symptoms will rebound......with a vengeance. So don't stop even once you start feeling better.

Ladies, it is time to speak up to your lovers, girlfriends, and doctors about vaginal dryness and vaginal atrophy and the effect it is having on your life.  An eighty-five-year-old widowed patient of mine told me things had been asleep down there for thirty years, but that little ovule I gave her "woke her up down there!" Although she did not have a lover, no longer did she rule it out! Ladies, it is never too late to treat these medical conditions. Remember, it is just as important to moisturize your vagina as it is your face.

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