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Vaginal Dryness. What it is and why it occurs

Published: 1 July, 2020 | 3'

The vulvovaginal area

The vulva is the first line of defense to protect the genital tract from infection. The skin in this area differs from other areas of our body in terms of hydration, friction, permeability and irritation.

The vagina, on the other hand, is the fibromuscular canal that extends from its external opening at the vulva to the cervix. It is composed mainly of smooth muscle covered with a non-keratinized epithelial lining that, until menopause, is thick, with folds that are kept moist by fluid secreted through the vaginal wall and mucus from the glands inside.

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Lubrication and bacterial flora

This environment maintains the appropriate physiological conditions, in relation to the presence of the natural microflora (mainly Lactobacillus spp.), and to the pH that is slightly alkaline. Prolonged dryness of the skin of the vulva significantly reduces this pH.

Lubrication in the vaginal area has several functions such as reducing friction during sex or protecting sperm. The hormone estrogen is responsible for keeping this fluid and the lining of the vagina healthy and flexible.

If the levels of this hormone are altered, vaginal dryness may appear along with other symptoms such as pain during sex and risk of infection.

Vaginal dryness is prevalent among women of all ages, but is particularly common during and after menopause.

Causes of vaginal dryness

The causes of decreased vaginal lubrication are very diverse. They include hormonal changes, menopause, pregnancy and postpartum, breastfeeding, stress, diabetes, or other factors such as radiation and chemotherapy treatments.

It can also occur due to the use of antidepressants, oral contraceptives, condoms, IUDs, antibiotics, as well as other external factors.

Vaginal dryness in pregnancy

During the gestation period the woman's body undergoes various hormonal changes, generally with an increase in the levels of certain hormones such as estrogen, among others.

As a result, the tissues of the vagina become less elastic and cause irregularities in their normal state.

Estrogen levels can also decrease because of childbirth, which is why vaginal dryness can occur during breastfeeding.

Vaginal dryness in menopause

Vaginal dryness is very common during menopause due to the drop in estrogen levels, thereby decreasing the moisture in the walls of the vagina.

This reduction in estrogen production begins to occur in the transition period to menopause, called perimenopause, until the total disappearance of menopause. This is when the vagina becomes thinner and less elastic.

Vaginal dryness due to stress

Stress can also cause vaginal dryness, since this psychological state generates an increase of cortisol in the blood, producing in turn an imbalance in the secretion of hormones, including estrogen, directly related to the hydration of the vagina.

Vaginal dryness during chemotherapy treatments

Treatments such as chemotherapy can also cause a decrease in estrogen production, in turn causing symptoms similar to those of menopause such as thinning of the vaginal wall and dryness.

Vaginal infections and dryness

Certain infections affecting the genital area may also be related to vaginal dryness, as well as to the excessive use of soaps or hygiene products.

This lack of lubrication can increase the chances of having episodes of cystitis or urinary tract infections, as well as other vaginal infections such as candidiasis or bacterial vaginosis.

Symptoms of vaginal dryness

Vaginal dryness can cause discomfort which, in turn, can lead to:

  • A burning or stinging sensation.
  • Pain during sex, which may cause loss of interest in sex.
  • Slight bleeding after intercourse.
  • Recurring urinary tract infections.

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Relieving vaginal dryness

Specific moisturizers for the intimate area are often a good option to help reduce dryness and discomfort. It is important that these products respect the pH of the vaginal flora.

Thus, its formulation must be water-based and specifically for vaginal use, without containing perfumes that may cause irritation.

Similarly, to alleviate the symptoms of vaginal atrophy, which is directly related to reduced vaginal lubrication, the Spanish Association of Gynecology and Obstetrics recommends maintaining proper hygiene and health habits with proper hydration or the use of moisturizers and lubricants.

If the symptoms become very uncomfortable and persist, you should always go to your health specialist for a proper diagnosis.