Vaginal dryness is a common condition affecting up to 40% of women (Baziad, 2016).
The prevalence of vaginal dryness varies depending on the woman’s age. It is characterized by a feeling of dryness, irritation, or burning in the vaginal area, often accompanied by pain during sexual intercourse.
This article aims to explore the causes of vaginal dryness and suggest some solutions to remedy it.
Causes of Vaginal Dryness
Vaginal dryness is primarily related to a deficiency in estrogen.
This deficiency is often observed in the following situations: in cases of low body weight in women who have menstrual cycles (or are of an age to have them), during breastfeeding, or at menopause.
Low Body Weight
The amount of body fat plays a major role in the production of sex hormones, including oestrogen. Low body weight associated with irregular or absent menstrual cycles indicates an oestrogen level that is too low.
Irregular cycles or amenorrhea should be taken into account. Indeed, beyond the unpleasant symptoms that a lack of oestrogen can cause (vaginal dryness, hair loss, depression, hot flashes, night sweats, fine lines, urinary leakage), it exposes women to an increased risk of cardiovascular and bone disorders.
Breastfeeding
When breastfeeding, the body produces large amounts of prolactin. This hormone plays a key role in milk production. However, prolactin inhibits the secretion of gonadotropin-releasing hormone (GnRH), which leads to reduced release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones are crucial for stimulating the ovaries to produce oestrogen.
As a result, when oestrogen levels remain low, menstrual cycles are irregular or absent, and symptoms related to oestrogen deficiency, such as vaginal dryness, may occur.
Menopause
At menopause, the ovaries stop producing pestrogen. These hormones are then primarily produced by adipose tissue (fat). However, postmenopausal women who are thin or have very low production of DHEA from the adrenal glands (a hormone crucial for health and longevity) are at higher risk of experiencing vaginal dryness.
Furthermore, postmenopausal women with diabetes are also more likely to develop vaginal dryness (Huang et al., 2010).
Other Causes
Certain medications can lead to vaginal dryness by reducing vaginal secretions.
Smoking affects blood circulation, including in the vaginal area, which can alter vaginal moisture and promote dryness.
Certain conditions, such as Sjögren’s syndrome, can also induce vaginal dryness.
Vaginal Dryness, the risks
A lack of oestrogen can cause vaginal atrophy, which in turn can affect the urinary system (Baziad, 2016). Associated symptoms may include frequent urges to urinate, urinary incontinence, or urinary infections.
Moreover, the mucosa of the cervix, vagina, and vulva becomes thinner, which can lead to frequent bleeding.
In cases of vaginal dryness, the vaginal pH, which is normally between 3.5 and 5, can become more alkaline, reaching a pH of 6 to 8. This increase in pH promotes the growth of pathogens.
Finally, due to the pain and difficulties associated with sexual intercourse, the impact of vaginal dryness on the couple’s life should not be underestimated. It is essential to discuss with your partner to find solutions together.
Vaginal Dryness, some solutions
Prevention is key. It is recommended to avoid irritating products such as scented soaps, vaginal douches, or inappropriate intimate sprays, as these can dry out the vaginal mucosa and worsen dryness. Simple water cleaning is usually sufficient to maintain good hygiene.
Here are some solutions.
Medical Solutions
Local administration of oestrogen may be considered under medical advice. Taking DHEA (under medical advice) may also provide rapid results, often noticeable within two weeks (Labrie et al., 2009).
It is important to note that the incidence of breast cancer does not seem to be significantly different between women using hormone replacement therapy (HRT) and those who gain 5 kg or drink two glasses of alcohol per day (Baziad, 2016).
The solutions presented here can relieve vaginal dryness. However, to achieve long-term improvement, it is essential to treat the underlying cause of vaginal dryness.
In some cases, especially during menopause, if phytotherapy (tailored to each woman) and “natural” remedies have not given satisfactory results, hormone replacement therapy may be offered by a gynaecologist or functional medicine doctor. I do not mention plants here, as some may have contraindications. Therefore, it is crucial to consult a professional for personalised advice.
Sea Buckthorn Oil
A study conducted on 98 postmenopausal women with symptoms of vaginal dryness, itching, or burning showed that consuming 3 grams of sea buckthorn oil for 3 months significantly improved symptoms (Larmo et al., 2014).
Hyaluronic Acid
Vaginal gel with hyaluronic acid (Hyalofemme) and estriol cream (Ovestin) can significantly improve vaginal dryness in postmenopausal women, with respective improvement rates of 84.44% and 89.42% after 10 applications (Chen et al., 2013). Local hyaluronic acid gel can be considered a valid alternative to oestrogen-based hormone treatments (Dos Santos et al., 2021).
Vitamin E
Vitamin E is a fat-soluble vitamin with antioxidant and restorative properties (Ziagham et al., 2012).
Studies have shown that vitamin E relieves the symptoms of vaginal atrophy. Therefore, the use of vaginal suppositories containing vitamin E is recommended for women suffering from vaginal atrophy who do not wish to or cannot receive topical oestrogen treatment (Ziagham et al., 2013).
Before or alongside the local use of vitamin D, you can consume foods rich in vitamin E (avocado, hazelnuts, almonds) and/or some wheat germ oil, which is very rich in vitamin E. Oral supplementation of vitamin E should not be done long-term without a blood test. Avoid supplementation of more than 1 g of vitamin E/day (or 1500 IU).
Coconut Oil
Topical application of virgin coconut oil appears to reduce vaginal dryness. A study conducted with 50 postmenopausal women (25 control) showed that daily application of coconut oil for 30 days significantly reduced vaginal dryness (Albornoz et al., 2023).
Aloe Vera
A study conducted on 60 postmenopausal women suffering from vaginal dryness showed that the local use of aloe vera cream for 6 weeks significantly reduced vaginal dryness, similarly to an oestrogen-based cream (Poordast et al., 2021). The study concluded that an aloe vera cream can be an interesting alternative (Poordast et al., 2021).
Vaginal Dryness, the takeaways
Vaginal dryness, primarily caused by a lack of oestrogen, is not inevitable and should be appropriately addressed.
For women of menstruating age, the focus will be on the regularity of cycles.
For postmenopausal women, it is possible to “boost” oestrogen and DHEA levels. If phytotherapy, micronutrition, and a healthy lifestyle, accompanied by “natural” remedies, are insufficient, local oestrogen administration and/or DHEA supplementation (measured in the blood as DHEA sulfate) can provide real comfort and prevent risks associated with oestrogen deficiency.
Are you suffering from vaginal dryness? Contact me to discuss it.
Sources
Literature
Albornoz, M. A., Burke, J. F., & Threlfall, E. K. (2023). Virgin Coconut Oil in Paste Form as Treatment for Dyspareunia and Vaginal Dryness in Patients With and Without Rheumatic Autoimmune Diseases: An Efficacy and Safety Assessment Pilot Study. Cureus, 15(6).
Baziad, A. (2016). Diagnosis and management of vaginal dryness in menopause. Majalah Obstetri Dan Ginekologi, 24(2), 70-73.
Chen, J., Geng, L., Song, X., Li, H., Giordan, N., & Liao, Q. (2013). Evaluation of the efficacy and safety of hyaluronic acid vaginal gel to ease vaginal dryness: a multicenter, randomized, controlled, open‐label, parallel‐group, clinical trial. The journal of sexual medicine, 10(6), 1575-1584.
Dos Santos, C. C. M., Uggioni, M. L. R., Colonetti, T., Colonetti, L., Grande, A. J., & Da Rosa, M. I. (2021). Hyaluronic acid in postmenopause vaginal atrophy: a systematic review. The journal of sexual medicine, 18(1), 156-166.
Huang, A. J., Moore, E. E., Boyko, E. J., Scholes, D., Lin, F., Vittinghoff, E., & Fihn, S. D. (2010). Vaginal symptoms in postmenopausal women: self-reported severity, natural history, and risk factors. Menopause, 17(1), 121-126.
Labrie, F., Archer, D., Bouchard, C., Fortier, M., Cusan, L., Gomez, J.-L., Girard, G., Baron, M., Ayotte, N., & Moreau, M. (2009). Intravaginal dehydroepiandrosterone (Prasterone), a physiological and highly efficient treatment of vaginal atrophy. Menopause, 16(5), 907-922.
Larmo, P. S., Yang, B., Hyssälä, J., Kallio, H. P., & Erkkola, R. (2014). Effects of sea buckthorn oil intake on vaginal atrophy in postmenopausal women: a randomized, double-blind, placebo-controlled study. Maturitas, 79(3), 316-321.
Poordast, T., Ghaedian, L., Ghaedian, L., Najib, F. S., Alipour, S., Hosseinzadeh, M., Vardanjani, H. M., Salehi, A., & Hosseinimehr, S. J. (2021). Aloe Vera; A new treatment for atrophic vaginitis, A randomized double-blinded controlled trial. Journal of Ethnopharmacology, 270, 113760.
Ziagham, S., Abbaspoor, Z., & Abbaspour, M. R. (2012). Effect of hyaluronic acid and vitamin E vaginal tablets on atrophic vaginitis: A randomized controlled trial. Afr J Pharm Pharmacol, 6(45), 3124-3129.
Ziagham, S., Abbaspoor, Z., Safyari, S., & Rad, P. (2013). Effect of vitamin E vaginal suppository on atrophic vaginitis among postmenopausal women. Jundishapur Journal of Chronic Disease Care, 2(4).