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Vaginal dryness

Vaginitis - atrophic; Vaginitis due to reduced estrogen; Atrophic vaginitis; Menopause vaginal dryness

Vaginal dryness is present when the tissues of the vagina are no longer well-lubricated and healthy.

Causes

Atrophic vaginitis is caused by a decrease in estrogen.

Estrogen keeps the tissues of the vagina lubricated and healthy. Normally, the lining of the vagina makes a clear, lubricating fluid. This fluid makes sexual intercourse more comfortable. It also helps decrease vaginal dryness.

If estrogen levels drop off, the vaginal tissue shrinks and becomes thinner. This causes dryness and inflammation.

Estrogen levels normally drop after menopause. The following may also cause estrogen levels to drop:

  • Medicines or hormones used in the treatment of breast cancer, endometriosis, fibroids, or infertility
  • Surgery to remove the ovaries
  • Radiation treatment to the pelvic area
  • Chemotherap.
  • Severe stress, depression, or intense exercise

Some women develop this problem right after childbirth or while breastfeeding. Estrogen levels are lower at these times.

The vagina can also become further irritated from soaps, laundry detergents, lotions, perfumes, or douches. Certain medicines, smoking, tampons, and condoms may also cause or worsen vaginal dryness.

Symptoms

Symptoms include:

  • Burning on urination
  • Light bleeding after intercourse
  • Painful sexual intercourse
  • Slight vaginal discharge
  • Vaginal soreness, itching or burning

Exams and Tests

A pelvic exam shows that the walls of the vagina are thin, pale or red.

Your vaginal discharge may be tested to rule out other causes for the condition. You may also have hormone level tests to find out if you are in menopause.

Treatment

There are many treatments for vaginal dryness. Before treating your symptoms on your own, a health care provider must determine the cause of the problem.

  • Try using lubricants and vaginal moisturizing creams. They will often moisten the area for several hours, up to a day. These can be bought without prescription.
  • Use a water-soluble vaginal lubricant during intercourse may help. Products with petroleum jelly, mineral oil, or other oils may damage latex condoms or diaphragms.
  • Avoid scented soaps, lotions, perfumes, or douches.

Prescription estrogen can work well to treat atrophic vaginitis. It is available as a cream, tablet, suppository, or ring. All of these are placed directly into the vagina. These medicines deliver estrogen directly to the vaginal area. Only a little estrogen is absorbed into the bloodstream.

You may take estrogen (hormone therapy) in the form of a skin patch, or in a pill that you take by mouth if you have hot flashes or other symptoms of menopause.

Women should discuss the risks and benefits of estrogen replacement therapy with their provider.

Outlook (Prognosis)

Proper treatment will ease symptoms most of the time.

Possible Complications

Vaginal dryness can:

  • Make you more likely to get yeast or bacterial infections of the vagina.
  • Cause sores or cracks in the walls of the vagina.
  • Cause pain with sexual intercourse, which may affect your relationship with your partner or spouse. (Talking openly with your partner may help.)

When to Contact a Medical Professional

Call your provider if you have vaginal dryness or soreness, burning, itching, or painful sexual intercourse that does not go away when you use a water-soluble lubricant.

References

Eckert LO, Lentz G. Infections of the lower and upper genital tracts. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 23.

Grady D, Barrett-Connor E. Menopause. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 240.

Lobo RA. Menopasue and care of the mature woman. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 14.

    • Female reproductive anatomy

      Female reproductive anatomy - illustration

      External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries and cervix.

      Female reproductive anatomy

      illustration

    • Causes of painful intercourse

      Causes of painful intercourse - illustration

      Dyspareunia (painful intercourse) refers to pain in the pelvic area during or after intercourse, and can occur in both women and men. Besides possible physical causes, pain may occur in association with psychological factors such as previous sexual trauma.

      Causes of painful intercourse

      illustration

    • Uterus

      Uterus - illustration

      The uterus is a hollow muscular organ located in the female pelvis between the bladder and rectum. The ovaries produce the eggs that travel through the fallopian tubes. Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. The main function of the uterus is to nourish the developing fetus prior to birth.

      Uterus

      illustration

    • Normal uterine anatomy (cut section)

      Normal uterine anatomy (cut section) - illustration

      The uterus is a muscular organ with thick walls, two upper openings to the fallopian tubes and an inferior opening to the vagina.

      Normal uterine anatomy (cut section)

      illustration

      • Female reproductive anatomy

        Female reproductive anatomy - illustration

        External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries and cervix.

        Female reproductive anatomy

        illustration

      • Causes of painful intercourse

        Causes of painful intercourse - illustration

        Dyspareunia (painful intercourse) refers to pain in the pelvic area during or after intercourse, and can occur in both women and men. Besides possible physical causes, pain may occur in association with psychological factors such as previous sexual trauma.

        Causes of painful intercourse

        illustration

      • Uterus

        Uterus - illustration

        The uterus is a hollow muscular organ located in the female pelvis between the bladder and rectum. The ovaries produce the eggs that travel through the fallopian tubes. Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. The main function of the uterus is to nourish the developing fetus prior to birth.

        Uterus

        illustration

      • Normal uterine anatomy (cut section)

        Normal uterine anatomy (cut section) - illustration

        The uterus is a muscular organ with thick walls, two upper openings to the fallopian tubes and an inferior opening to the vagina.

        Normal uterine anatomy (cut section)

        illustration

      Review Date: 11/5/2015

      Reviewed By: Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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