HELP!  My vagina is NOT HAPPY! – causes of vaginal dryness and what to do about it

Believe it or not, this is a relatively common problem.  It’s VERY common for females to experience dryness after having a baby or when they begin the transition into menopause, though it’s possible to experience dryness in any stage of your life. 

Vaginal dryness can manifest as pain with sex, more frequent UTIs, or feelings like itching or irritation like you have an infection. 

Causes of Vaginal Dryness:

A common cause is decreased estrogen.  When estrogen levels drop, the tissue in the vagina becomes more fragile and less elastic and the glandular tissue tends to secrete less lubrication. 

Medications can also cause vaginal dryness. 

Some common culprits include:

  • progesterone only birth control methods such as the progesterone IUDs, depo provera (birth control shot), progesterone only birth control pills, and the implant (Nexplanon).  Progesterone can lower glycogen in the vaginal mucosa which causes less lubricant production.
  • Blood pressure medications
  • Allergy medications
  • Antiseizure meds

If you’re taking any prescription medications, it’s best to check with your doctor to see if vaginal dryness can be a side effect and if any adjustments can be made.

There are also medical conditions associated with vaginal dryness.  Certain dermatologic conditions such as eczema, psoriasis, and lichen sclerosis can cause dryness on the vulva and vagina.  Sjogren’s syndrome is an autoimmune condition associated with dry eyes and dry mouth, but can also cause a dry vagina.

Treatment Options:

Ok, so now that we know what causes vaginal dryness, let’s talk about what to do about it!

Here are some tips that may help with how vaginal dryness relates to sex:

  1. Start with increased foreplay – touching, fingering, oral sex – whatever works for you!  Foreplay causes arousal which leads to increased blood flow to our vulva and vagina and natural secretion of lubricants.  You may find that if you spend just an extra 10 minutes with foreplay, this fixes the issue of feeling dry with penetration!  Of note, the amount of lubrication or wetness you have doesn’t necessarily correlate with arousal.  What’s important here is that the foreplay improves the sensation of dryness.
  2. Lubricants – lubricants can be a great and easy addition to help sex be more comfortable and fun.  If you’ve never used lube during sex, even if you are someone who doesn’t have an issue with vaginal dryness, it might be worth a try!  Some females report sex feels different and more pleasurable with them.  There are MANY types of lube on the market, so finding the right one for you is important.  Check out this previous post for more info!
  3. Vaginal moisturizers – similar to lubricants, but vaginal moisturizers are used more regularly (not just with sex) to improve vaginal moisture at all times of day.  If you are struggling with vaginal dryness that isn’t just an issue when you’re having sex, then this may be the right choice for you.  They can be silicone, water based, oil based or even made from hyaluronic acid. There are many options on the market and they can all be purchased over the counter without a prescription. Typically, these are used 2 to 3 nights per week in order to maintain vaginal moisture.
  4. Vaginal estrogen – especially if your vaginal dryness is related to low estrogen (your doctor can help make this determination), prescription vaginal estrogen may be the right treatment option for you.  It comes in many forms – cream, suppository, tablet, or ring and is typically used 2 nights per week.

Vaginal dryness is not pleasant and is unfortunately often confused with other vaginal issues.  But getting a correct diagnosis and exploring the many treatment options available will hopefully have you back in happy vagina land before you know it! 

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