Menopausal Vaginal Dryness: Why it happens and what you can do about it
A lack of estrogen to your vulva and vagina can cause a range of symptoms that, although very common, are often not mentioned due to embarrassment. Vaginal dryness can cause irritation, burning, and pain with intercourse and in extreme cases it can even hurt to sit down. It’s common during perimenopause and menopause and is an area that should be talked about more often as there are things that can be done that can really help.
The hormone estrogen keeps your vagina healthy by acting as a natural lubricant. It also stimulates the cells in the lining of your vagina to encourage the presence of ‘good’ bacteria that protects against infection. As estrogen levels in your body start to decline during the perimenopause and menopause, the vulva, vagina, and urinary tract can start to suffer from a lack of estrogen. The tissue lining your vagina thins (known as vaginal atrophy) and becomes drier. Atrophic vaginitis (vulvovaginal atrophy) is a common condition that can occur when the ovaries produce a decreased amount of estrogen. One of the common symptoms for this is vaginal dryness.
Your bladder and the tube running from it (urethra) also become thinner and become weaker which can cause you to need the toilet more often. Estrogen also helps cells to fight off harmful bacteria, a lack of this hormone makes you prone to cystitis (urinary tract infection).
The hormone estrogen helps to keep the vagina moist and to maintain the thickness of the lining of the vagina. After and around the time of menopause, your body makes less estrogen. Estrogen is a hormone that helps maintain the vagina’s lubrication, elasticity, and thickness. Low levels of estrogen can cause thinning, drying, and inflammation of vaginal walls. This is called vaginal atrophy.
What can you do?
First of all talk to your doctor and get the help and support you need. Below are some options of very effective things you can do to help relieve this uncomfortable issue.
Local estrogen
Because these symptoms are due to a lack of estrogen, a very effective solution is to put estrogen directly on the affected area. This is known as ‘local’ or ‘topical’ estrogen and it is not the same as the estrogen you take as part of your HRT; vaginal estrogen treatments can be taken safely for a long time, with no associated risks.
Local estrogen is available via a prescription your healthcare professional can advise on which type would be best for you, there are two types of estrogen used – estradiol and estriol – and three main ways to absorb the estrogen directly from the vagina and surrounding area: Pessary: The most common choice of vaginal estrogen is to use a pessary. This is a small tablet you insert into the vagina, using an applicator. It is administered daily for the first two weeks, and then twice weekly after that. Women usually insert the pessary at night time so they can stay in place in the vagina for several hours. If twice weekly doesn’t improve symptoms, it can be used more frequently under advice from your healthcare professional.
Pessaries
There is another type of pessary that is different to other estrogen preparations which contains DHEA, a hormone that our body naturally produces. Once positioned in the vagina, the DHEA is converted to both estrogen and testosterone. It is can be used with or without an applicator and the usual dose is one pessary (Newson Health 2020).
Nutrition and Vaginal health
What you eat can also have an impact on your vaginal health.
A diet rich in wholesome, minimally processed foods can help to support your body as a whole. A mediterranean style diet is often recommended as a healthy diet, it is also a perfect example of a whole-foods rich diet beneficial for vaginal health and the menopausal time period.
Vagina healthy foods
Fermented dairy products like yogurt
Prebiotic and probiotic rich foods
Research suggests that daily cranberry juice consumption (watch out for added sugar) could help reduce the risk for recurrent UTI ‘s
Omega 3 oils found in fatty fish
Phytoestrogen rich foods like minimally processed soy foods like tofu, tempeh, and edamame
Don’t forget to drink plenty of water
There are plenty of good reasons to limit sugar in your diet, from supporting heart health to aiding in weight management. Moderating your sugar intake matters for vaginal health too. In addition to having a negative impact on your vaginal microbiome and exacerbating symptoms like dryness or irritation, excessive sugar consumption may also increase the risk for yeast infections in women who are prone to them.
Sea Buckthorn
Sea buckthorn, derived from the berries, leaves, and seeds of the sea buckthorn plant, is a remarkable natural remedy that's gaining popularity for its ability to alleviate dryness in various parts of the body, including vaginal dryness and dryness in the eyes, mouth, and nose. This vibrant orange berry is packed with nutrients, including vitamins A, C, and E, omega-3, 6, 7, and 9 fatty acids, and flavonoids, which collectively contribute to its healing and rejuvenating properties.
Research suggests that sea buckthorn oil can be particularly beneficial for postmenopausal women experiencing vaginal dryness, a common symptom due to hormonal changes. The omega-7 fatty acids in sea buckthorn oil are known for their ability to support mucous membranes, thereby improving moisture levels in the vagina as well as in the eyes, mouth, and nasal passages.
For dry eyes, studies indicate that sea buckthorn oil can improve eye comfort, likely due to its anti-inflammatory and moisturising effects. Similarly, its benefits extend to relieving dryness in the mouth and nose, making it a versatile remedy for those dealing with discomfort in these areas.
While sea buckthorn oil appears promising for these conditions, it's important to approach its use with care, especially for internal issues like vaginal dryness. Consulting with a healthcare provider or a specialist in women's health and nutrition is advisable to ensure it's appropriate for your individual needs and to discuss the best form and dosage.
Incorporating sea buckthorn oil into your routine could be a natural way to address dryness, but it's part of a holistic approach to health. A balanced diet, adequate hydration, and a tailored skincare regimen also play crucial roles in maintaining moisture levels in the body and supporting overall well-being.
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References
Barrientos-Durán, A., Fuentes-López, A., de Salazar, A., Plaza-Díaz, J., & García, F. (2020). Reviewing the composition of vaginal microbiota: inclusion of nutrition and probiotic factors in the maintenance of eubiosis. Nutrients, 12(2), 419. https://www.mdpi.com/2072-6643/12/2/419
Muhleisen, A. L., & Herbst-Kralovetz, M. M. (2016). Menopause and the vaginal microbiome. Maturitas, 91, 42-50. https://www.sciencedirect.com/science/article/abs/pii/S0378512216301244
Newson Health (2020) Vaginal Dryness [Online]. Available at: https://www.newsonhealth.co.uk/
Naumova, I., & Castelo-Branco, C. (2018). Current treatment options for postmenopausal vaginal atrophy. International journal of women's health, 10, 387. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074805/
Waetjen, L. E., Crawford, S. L., Chang, P. Y., Reed, B. D., Hess, R., Avis, N. E., ... & Gold, E. B. (2018). Factors associated with developing vaginal dryness symptoms in women transitioning through menopause: a longitudinal study. Menopause (New York, NY), 25(10), 1094. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6136974/
