Vaginal dryness: causes, symptoms and current treatments
Why vaginal dryness develops, the symptoms it produces beyond sexual life, and the treatment options — from moisturisers and local oestrogen to laser.
In consultations about women's health, one problem comes up again and again — experienced by a great many women, yet rarely spoken about: vaginal dryness.
Most women see it as a natural consequence of ageing or the menopause, something to be endured. In fact it affects both quality of life and sexual health, and it can be managed successfully with what medicine offers today.
What causes it
The single most important factor keeping the vaginal area healthy, elastic and moist is oestrogen. As oestrogen levels fall, the vaginal tissue thins, loses elasticity and produces less of its natural lubrication. The main situations in which oestrogen falls and dryness is common are:
- The menopause and perimenopause. Slowing ovarian function with age is the most common cause of all.
- After childbirth and while breastfeeding. The shift in hormone balance after pregnancy and during active breastfeeding can cause dryness.
- Cancer treatment. Chemotherapy, radiotherapy and hormone-suppressing medicines (aromatase inhibitors and others), particularly in breast cancer, can produce the effect of an early menopause and with it dryness.
- Stress, smoking and certain medicines. Intense stress, smoking and some allergy or antidepressant medicines can all affect vaginal moisture.
The symptoms
Vaginal dryness makes daily life difficult as well as sexual life. The most common symptoms are:
- burning, stinging and itching in the vaginal area
- pain during sex (dyspareunia)
- frequently recurring urinary and vaginal infections
- discomfort and irritation during ordinary activity — walking, or wearing tight clothing
Treatment
The aim is to ease the symptoms and support the tissue in regaining its health. Depending on the situation:
- Moisturisers and lubricants. The first step: hormone-free support used to provide comfort during sex and to ease everyday dryness.
- Hormonal treatment. Under medical supervision, local (regional) oestrogen creams and pessaries, or systemic hormone therapy, help nourish the tissue.
- Hyaluronic acid. Applied to the vaginal tissue, hyaluronic acid — which increases the skin's capacity to hold moisture — supports a reduction in dryness and a return of elasticity.
Laser treatment
Among the methods attracting most attention in recent gynaecological practice is vaginal laser (carbon dioxide/CO2 or Erbium:YAG). It is a comfortable option particularly for women who cannot use hormone therapy — for example those with a history of breast cancer — or who prefer not to.
How it works. The laser delivers controlled heat energy to the deeper layers of the vaginal tissue. That heat stimulates the aged collagen fibres and starts the production of new collagen and elastin, while also increasing blood flow to the area. The renewed tissue begins to regain its former thickness, elasticity and natural moisture. As healthy vaginal flora — the beneficial bacteria — returns, a protective barrier against frequently recurring infections also forms.
What the procedure involves.
- carried out in a clinic setting, taking on average 15-20 minutes
- not an operation; there is no incision and there are no stitches
- generally well tolerated, and requiring no anaesthesia
- patients return to their normal day immediately afterwards
See also genital laser treatment and menopause treatment.