Unlike menstruation, menopause does not start in one day, it is a drawn out process that slowly happens over the course of several years. However, during perimenopause, menopause and even postmenopause a woman can experience various unpleasant symptoms including weight gain, joint pain, hot flashes, night sweats and vaginal dryness.
Vaginal dryness, also known as vaginal atrophy, is experienced by over estimated 80% of perimenopausal women; while as many as 50% of postmenopausal women suffer from the condition. Furthermore, vaginal dryness primarily affects women between 40 – 65 years of age, but it can affect any woman regardless of her age.
Why does vaginal dryness occur?
Mucus membranes located at the mouth of the uterus keep a woman's vagina moist. The estrogen in a woman's body helps the membranes generate lubrication which assays the vagina in staying moist, flexible and strong. In addition, the lubricant contains a small level of acidity which works to protect the vagina from infection by stopping foreign bacteria from invading.
Due to the fact that estrogen plays a vital role in maintaining a moist and flexible vagina, the decrease in estrogen levels that occurs during menopause means a decrease in lubrication production. As a result, the vagina becomes thin and dry, and the vaginal walls become weaker and increasingly sensitive. Moreover, with less lubrication, acid levels are naturally non-existent which can lead to a higher risk of infections such as yeast and urinary tract infections.
Additionally, the more a woman's estrogen levels decrease, the less blood will circulate to the pelvis tissues which will cause the vagina to become thin and droop. Occasionally, the vulva and vagina will likely look different because the fat and tissue around the vaginal area will start to vanish.
What does a woman experience with vaginal dryness?
Itching – Just as itching is a symptom of dry skin, so is it a symptom of vaginal dryness. Itching is a result of tightening in the vaginal area from lack of moisture. It can be very irritable.
Pain during sexual intervention – The vagina becomes extremely dry and fragile without normal mucus production. Therefore, it can no longer take rough penetration. Menopaal women who experience pain during intercourse often have vaginal bleeding or spotting after having sex. Bleeding results from a tear in the vaginal wall from forceful entry. Many women who suffer from vaginal dryness tend to avoid sex as they find it too painful and receive no enjoyment from it.
Urinary incontinence and infections – Urinary incontinence (UI) is when the body accidentally leaks urine. The decrease in estrogen levels causes fatigue in the vaginal walls, which reduces a woman's ability to control urine from escaping unwillingly. About 40% or more of menopausal women experience UI. Also, as was previously mentioned, vaginal dryness increases a woman's chance of developing yeast infections and urinary track infections.
How can vaginal dryness be treated?
There are different treatment options to help women increase the moisture in their vaginal region. One of the most common treatments is using lubricants during sex to allow for a more enjoyable experience. Topical creams and moisturizers can be purchased over-the-counter and often provide 24 hour relief from itching.
Many doctors actually recommend that women with vaginal dryness engage in more sexual activity. This may sound like a bizarre treatment, but intercourse actually stimulates the mucus glands and helps to make the vagina moist. In many cases, women who abstain from sex find that their dryness becomes worse.
Finally, if a woman has persistent vaginal dryness, her doctor may recommend oral or topical prescription estrogen therapy.