Vaginal Dryness During Menopause: Causes and Solutions

Vaginal dryness during the menopause is a topic that often doesn’t get the attention it deserves, yet it’s something most women experience as their bodies transition through this stage of life. While it may feel uncomfortable or even embarrassing to talk about, understanding and addressing vaginal dryness is crucial for your comfort, health, and overall well-being.

We’re going to break down why vaginal dryness happens during perimenopause and menopause, explore the common symptoms, and most importantly, provide you with practical solutions to manage and alleviate this issue. Whether you’re just beginning to notice changes or have been dealing with discomfort for a while, this guide is here to help you feel more confident and in control of your health.

Let’s dive in!

Understanding the Causes:

Let’s start by exploring why vaginal dryness occurs during menopause. As our bodies prepare for menopause, estrogen levels fluctuate and eventually decline. Estrogen is the hormone responsible for keeping our vaginal tissues lubricated, elastic, and healthy. When estrogen levels drop, it’s common to experience dryness, itching, and even pain during intercourse.

According to the North American Menopause Society (NAMS), vaginal dryness affects over 50% of women during menopause. Based on my clinical experience, this number is closer to 90% but that is just my observation. Vaginal Dryness is part of a broader condition called genitourinary syndrome of menopause (GSM), which refers to the changes in the vagina, vulva, and bladder that occur during menopause.

Here’s how it works: Normally, estrogen helps maintain a healthy, acidic environment in the vagina. This acidity is crucial because it keeps the vaginal tissues stretchy, elastic, and well-lubricated, while also protecting against infections. However, as estrogen levels drop, the pH in the vagina rises, leading to less acidity. This change causes the vaginal tissues to become thinner, less elastic, and more prone to dryness, discomfort, and even urinary tract infections (UTIs).

GSM doesn’t just cause physical discomfort—it can also reduce sexual desire and make intercourse painful. What’s more, GSM is a progressive condition, meaning it tends to worsen over time if left untreated.

Practical Solutions:

Now that we know the causes, let's focus on the solutions! Here are some practical tips to help alleviate GSM:

1. Lubrication is your friend:

Over-the-counter lubricants can be a game-changer when it comes to reducing discomfort during intimacy. Look for water-based or silicone-based options, and don't be afraid to experiment to find what works best for you.

2. Embrace moisturizers:

Vaginal moisturizers, which are different from lubricants, can help maintain moisture in the vaginal area on a daily basis. For best results, use these regularly, even when you're not engaging in sexual activity, to keep your tissues healthy and hydrated.

3. Consider hormone therapy:

If your GSM is severe and impacting your quality of life, talk to your menopause care provider about hormonal therapy options. Local estrogen treatments, such as vaginal creams or suppositories, can help restore moisture and elasticity without the systemic effects of oral hormones. Local estrogen therapy is highly effective for treating vaginal dryness and is generally considered safe for long-term use.

4. Explore alternative therapies:

In addition to local estrogen, other options like vaginal DHEA (dehydroepiandrosterone) or ospemifene may be recommended. Vaginal DHEA helps improve vaginal tissue health by increasing local estrogen and androgen levels, while ospemifene is an oral medication that acts like estrogen on vaginal tissues, improving dryness and reducing discomfort during intercourse. These options can be effective alternatives and are often not talked about as much. If you're curious, ask your menopause provider at your next visit.

5. Stay hydrated:

Drinking plenty of water throughout the day can help keep your entire body, including your vaginal tissues, hydrated. Aim for at least 8 glasses of water daily and limit dehydrating beverages like caffeine and alcohol.

6. Communicate with Your Partner

One of the most important aspects of managing GSM is open communication with your partner. Don't be ashamed to discuss your concerns and needs. A supportive and understanding partner will be more than willing to work with you to find solutions that make intimacy enjoyable for both of you.

Remember, GSM is not a reflection of your desire or attraction to your partner. It's a common physiological response to hormonal changes, and there are many ways to work around it.

When to Seek Help:

If vaginal dryness persists despite trying these solutions, or if you experience severe discomfort, pain, or bleeding, it's time to consult your healthcare provider. They can help rule out any underlying health issues and provide more targeted treatment options. Treating GSM can improve your quality of life and there is no reason to suffer in silence.

Lastly, vaginal dryness or GSM during menopause is nothing to be ashamed of. It's a common experience that many of us will face, but with the right tools and mindset, we can navigate this challenge with confidence. Remember to prioritize your comfort, communicate openly, and don't hesitate to seek help when needed. You've got this!

Ready to take control of your menopause journey?

Don’t let vaginal dryness hold you back. If you’re living in BC and want to become a patient and create a personalized care plan, click here to book a consultation with me today. Your comfort and well-being are worth it!

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