SUFFER NO MORE IN SILENCE – VAGINAL DRYNESS
by Ngozi Osuagwu, MD | July 15th, 2018
Over 75 % of women will suffer from vaginal dryness in their lifetime. It can happen at any age but it is most common when a woman reaches menopause. Many women do not feel comfortable talking about vaginal dryness with their health care provider and would rather suffer in silence. You are not alone and you do not have to suffer. Talk with your health care provider.
Although, I am talking about vaginal dryness, this also includes vulva (the external genitalia) dryness. It is also called vulvovaginal atrophy, vulva atrophy or vaginal atrophy. The new term used in the medical world is genitourinary syndrome of menopause (GSM). The reason for this new term is that usually dryness not only affects the vulva and vagina but also the urethra – the hole where the urine comes from. The other reason for the change is that some people felt comfortable saying GSM instead of the word vagina.
Those with GSM which includes vaginal dryness may experience pain with sex, vaginal discomfort, burning sensation, itching, and abnormal discharge. The hormone estrogen that is produced by our ovaries keeps our vagina moist. When there is a reduction in the amount of estrogen, vaginal dryness occurs.
When it comes to treatment, it is not a one size fits all. What might help one woman might not help another. It is important to know your options. The most important thing for all women is to maintain good vulva hygiene. As I have mentioned in a previous blog (What is Really ‘Down There’?), treat your vulva like your face and keep it simple. The other thing that may be helpful is exercising the vagina – this can be done with sexual activity (with or without a partner), using lubricated dilators and pelvic physical therapy (you will need a referral).
The next is to be aware of your options if you have vaginal dryness:
Lubricants and moisturizers – there is a difference. A lubricant is used at the time that you are having sex to reduce the friction so that you decrease the pain. A moisturizer helps keep water in the vagina. It should be used on a regular basis. There are hybrids that can be used as a lubricant and a moisturizer. There are many in the market. There are water-based, silicone based and oil based. Oil based can break down latex condoms. Read the labels. Avoid those that contain paraben, glycerin, and alcohol. Also, note that some of the best lubricants and moisturizers may be bought online.
Estrogen – you are replacing what has decreased in your body. Estrogen for the vagina are low dose and come in a tablet , ring or cream form.
Ospemifene (Osphena – you will need a prescription) – a medication that you take by mouth – it works like Estrogen but does not contain the hormone. It is FDA approved to help with painful intercourse.
Intravaginal dehydroepiandrosterone (Intrarosa – will need a prescription) – a hormone that changes to estrogen when in the body. It is a suppository that you place in your vagina to help with painful intercourse.
CO2 Laser – This is not covered by the insurance. Laser therapy in the vagina – you will need about 3 sessions – it helps with thickening the walls of the vagina and adds moisture to the vagina.
The bottom line – there are many options for managing vaginal dryness and there is no need to suffer in silence. Talk with your health care provider.
This is the fourth part of our five part series- Suffer No More in Silence.
Suffer No More in Silence – Urinary Incontinence
