Feeling like an arid desert in your nether regions? Vaginal dryness is a common condition for a number of reasons, but it's rarely a hot topic at the dinner table. The condition is usually associated with the menopause, but around 17 per cent of women aged 18 to 50 will also experience vaginal dryness at some point.
We speak to Dr Karen Morton a gynaecologist and obstetrician, and Krystal Woodbridge, a psychosexual therapist at the College of Sexual Relationship Therapists (COSRT) about managing and overcoming vaginal dryness:
1. Vaginas produce two types of lubrication
It's a little known fact that vaginas produce two separate types of natural lubrication. One is for everyday maintenance and is produced by the glands on the surface of the cervix and the natural dampness of the vaginal wall. This slightly acidic moisture helps to keep the vaginal area clean, preventing infections such as thrush, while removing dead cells.
The other occurs when you become aroused. According to Morton, the Bartholin glands at the entrance of the vagina release a slippery mucus and the vaginal walls become even wetter, providing the extra lubrication needed to make sexual intercourse pleasurable.
2. Vaginas change during the menopause
During the menopause, many women experience changes in the vagina including blood supply, support, elasticity, sensitivity, lubrication and responsiveness, thanks to the decrease in the female hormone oestrogen.
'After the menopause, the pinkness, juiciness and waviness of the vaginal tissue diminishes, and it can start to look more like the skin on the back of your hand,' says Morton. 'If there's no lubrication, your vagina will feel dry and stiff, and sex can feel a bit like rubbing with sandpaper.'
Oestrogen also helps maintain a healthy ecosystem in your vagina. 'So, if there's a lack of moisture, the ecosystem may become disturbed and women may become more prone to an overgrowth of unhealthy germs,' says Morton. 'For example, bacterial vaginosis (BV), thrush and urinary tract infections (UTIs) can be more common.'
3. Many factors impact vaginal dryness
The menopause isn't the only cause of vaginal dryness. 'Anything that basically affects the hormone levels can temporarily cause vaginal dryness, such as childbirth and breastfeeding,' says Woodbridge.
'Anxiety and stress, the contraceptive pill or injection, some types of medication (antidepressants and antihistamines), chemotherapy and radiotherapy and of course, not being sufficiently aroused before sex can all contribute to vaginal dryness.
4. Vaginal dryness and your sex life
When it comes to being intimate, vaginal dryness can seriously impact your sex life. Penetration or even touching can feel uncomfortable and painful due to the dryness and thinning of the vaginal tissue. 'When sex starts to hurt, why would you want to do it? This of course has a massive impact on your sex life, your relationship and happiness in general' says Morton.
According to Woodbridge, if there are sexual intimacy problems, there may be linked to other problems. 'Quite often if the sex isn't there, people become disconnected. You shouldn't have to grin and bear it if sex is painful just to keep your partner happy, so it's really important to talk about it,' she says.
5. How to treat vaginal dryness
Reassuringly, for those who suffer with vaginal dryness, there are treatments available.
'If you're taking HRT, you shouldn't really need anything else,' says Morton. 'But if for one reason or the other you still experience dryness, you can give your vagina some nourishment using some oestrogen cream or a pessary, twice a week. This should be plenty to keep the tissue well-nourished, healthy and resistant to germs.'
And it isn't just the vagina that needs TLC. 'Sex can become very painful because the urethra (the tube that drains urine from the bladder), which has also become quite thin like the vaginal tissue, is being rubbed. This can lead to stinging when you pass urine. Oestrogen cream can help this,' she adds.
6. Don't be shy about lube
There are times in every woman's life when using lubricant can alleviate the unwelcome symptoms of dryness, and women shouldn't feel reluctant or embarrassed about it.
'You might want to try a vaginal moisturiser or lubricant to make sure you're fully lubricated before sex,' says Woodbridge. 'There's a massive choice out there now. I'd recommend using a silicone based lubricant as the water based one dries very quickly. If you suffer with thrush, I wouldn't use ones with glycerine in it, as this can upset the vaginal environment and cause irritation.'
7. Find the right sexual position
To get the best out of your sex life, it's important to find the most comfortable sexual position. Make sure you're really relaxed, aroused and using lots of lubricant beforehand, advises.
'Put a couple of pillows under the small of your back or under your bottom in missionary position, as this raises your pelvis up and makes entry easier,' says Woodbridge. 'Or doggy style can help because it changes the location of the pressure inside. If you're on top, it can help as you can control the pressure and the rhythm and look after you own comfort. So, it's about experimenting with what works and what doesn't.'
8. Don't suffer in silence
Whatever you do, remember you are not alone. 'It's really important to educate yourself about all the different options,' says Woodbridge. 'And don't be discouraged about going to speak to your GP or a gynaecologist.'
⚠️ If you notice any unusual symptoms, such as bleeding, an unusual discharge or smell, speak to your doctor.
Last updated: 09-10-19
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