Vaginal dryness can be caused by hormonal changes, irritants to delicate tissues, anxiety, and more. Here’s how to keep a lack of vaginal lubrication from causing painful sex.
Causes of vaginal dryness range from physiological factors, such as hormonal changes or medication side effects, to emotional and psychological issues, like a lack of desire or even anxiety. Fortunately, there are nearly as many options for dry vagina relief as there are causes.
This may be good news for the two-thirds of women over 60 who list vaginal dryness as one of their top two sexual health problems — the other being lack of interest in sex — as part of a survey of more than 800 women to identify sexual health challenges. The results were published in the August 2015 issue of the Journal of Women’s Health. Vaginal dryness can also be a concern for women younger than 60, however.
The first step in treating vaginal dryness is figuring out the source of the discomfort, especially if a dry vagina is causing painful sex. A number of conditions can lead to a lack of vaginal lubrication:
Changes in hormones. One of the most common causes of vaginal dryness is a decrease in estrogen levels during menopause or perimenopause, after childbirth, or during breastfeeding, according to the American Congress of Obstetricians and Gynecologists (ACOG). Cancer treatments such as chemotherapy and radiation to the pelvis can also lead to low estrogen and a decrease in vaginal lubrication. “The vagina depends on estrogen for health,” says Irwin Goldstein, MD, director of Sexual Medicine at Alvarado Hospital and San Diego Sexual Medicine in California.
Medications. Allergy and cold medications containing antihistamines as well as asthma medications can have a drying effect inside the body and cause reduced vaginal lubrication, according to Dr. Goldstein.
Insufficient arousal. In some cases, vaginal dryness may be caused by a low libido or sexual problems with a partner. “If a partner has poor performance and early ejaculation, it can contribute to vaginal dryness,” Goldstein says.
Irritants. The chemicals in soaps, hygiene products, dyes, and perfumes may cause problems. “Many women have allergies to detergents and soaps,” Goldstein says. “There can be irritants on things like underwear or towels.” Other allergens can actually include lubricants and objects that may be placed in the vagina, he adds.
Anxiety. Psychological and emotional factors like stress and anxiety can also interfere with sexual desire and lead to vaginal dryness when normal vaginal lubrication does not occur. “When a woman is anxious, there is insufficient blood flow,” Goldstein says, “so she will have dryness.”
How to Prevent and Treat Vaginal Dryness
Treatment for vaginal dryness depends on the cause. Women who experience problems with vaginal lubrication because of hormonal changes can often benefit from estrogen therapy, according to ACOG.
In some cases, doctors recommend localized treatments like vaginal estrogen inserts. For other women, especially those who have symptoms such as hot flashes in addition to vaginal dryness, an oral medication or a skin patch that releases estrogen throughout the body is an option, according to ACOG. And, in some cases, both approaches can be used together to effectively treat vaginal dryness.
“Local estrogen hormone treatments that are inserted into the vagina in the form of a ring, pellet, or cream can complement systemic medications that raise systemic levels of estrogen,” Goldstein says.
In addition to estrogen-based therapies, other approaches that may bring relief, especially from painful sex, include:
Lubricants. “There are a plethora of lubricants that can help vaginal dryness,” Goldstein says. They include silicone-based, oil-based, and water-based products, according to ACOG. Lubricants are usually used to make sex less uncomfortable rather than for long-term vaginal lubrication.
Moisturizers. Over-the-counter vaginal moisturizers can be an effective way to minimize vaginal dryness over several days with one application. Goldstein explains that “moisturizing agents help introduce water into the tissue of the vagina.”
Vaginal dryness is a common and frustrating condition, but there are ways to alleviate the discomfort. If a lack of lubrication is causing painful sex, be sure to talk to your doctor about all possible treatments.
— Reporting by Madeline Vann, MPH