Vaginal Dryness

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	Vaginal Dryness

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Signs, symptoms and indicators | Contributing risk factors | Recommendations


	Nearly every woman will experience vaginal dryness sometime in her life. It is most often associated with the normal decline or fluctuation in the female hormone estrogen, which can be triggered by giving birth, breastfeeding or menopause. Even taking certain medications, undergoing chemotherapy or radiation, exercising intensively, or being under a lot of stress can cause it. It is also common to experience vaginal dryness when douching too often, using tampons or just prior to menstruation.

Signs, symptoms & indicators of Vaginal Dryness:

Symptoms - Reproductive - General

Painful deep penetration during sex

Risk factors for Vaginal Dryness:

Sjogren's Syndrome

Low Estrogen Levels

The most common cause of vaginal dryness is lack of estrogen.

Low Testosterone Level, Female

Recommendations for Vaginal Dryness:

Ginseng, Korean - Chinese / Asian (Panax ginseng)

In one trial, panax ginseng for two to three months at 100mg of a standardized extract three times daily greatly improved vaginal dryness and painful intercourse in all of the women studied. Doses were then tapered to a maintenance level.

Women with a history of vaginal dryness and painful intercourse were asked to volunteer for biopsies of the vaginal mucosa. When examined microscopically, the biopsy specimens showed typical atrophy, with thinned epithelial layer and little to no mucous production. Macroscopic examination prior to biopsy of course showed the same changes. Tissue appearance and mucus levels returned to normal levels by the end of the study.

Although this research was not "double-blind" the biopsies and microscopic changes (as well as symptom remission) are definitely significant. (Wright) finds this approach very useful and reliable in practice, usually recommending 100 milligrams of a standardized extract three times daily until the objective is achieved. Quantities can often be lessened thereafter to a "maintenance level."

Estrogen Replacement

Systemic hormone replacement can provide relief, as can a plant-derived safe estriol cream used locally.

Progesterone

Some cases of vaginal dryness will improve with progesterone but small amounts of supplemental estrogen may be required.

Physical Medicine

Topical Applications

When estrogen levels are normal, topical applications will provide local assistance. You have many choices in lubricants - Replens, Astroglide, Vaseline, K-Y Jelly, Lubrifax, saliva, and mineral oil, to name a few. Yet surprisingly few studies have looked at the effect of vaginal lubricants on sperm motility. Unfortunately, what data we do have suggest that all but pharmaceutical-grade mineral oil seem to adversely affect fertility potential.

Vaginal lubrication is a result of both production of mucus by the cervix as well as fluid produced by cells in the vaginal wall during sexual arousal. Mucus production peaks during the middle of the menstrual cycle, as estrogen levels rise just before ovulation. Many factors can interfere with lubrication, including infection, surgery to treat abnormal Pap smears, and low estrogen levels.

KEY

		Strong or generally accepted link
		May do some good
		Likely to help
		Highly recommended

GLOSSARY

Chemotherapy: A treatment of disease by any chemicals. Used most often to refer to the chemical treatments used to combat cancer cells.

Estrogen: One of the female sex hormones produced by the ovaries.

Hormones: Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.

Menopause: The cessation of menstruation (usually not official until 12 months have passed without periods), occurring at the average age of 52. As commonly used, the word denotes the time of a woman's life, usually between the ages of 45 and 54, when periods cease and any symptoms of low estrogen levels persist, including hot flashes, insomnia, anxiety, mood swings, loss of libido and vaginal dryness. When these early menopausal symptoms subside, a woman becomes postmenopausal.