Asking for a friend: What can you do about vaginal dryness?
Vaginal dryness is something so personal that most women don’t talk about it with friends, said Tara Chute, MD, Cape Cod Hospital obstetrician and gynecologist. ”But if you did, it would be unbelievable how many women you’d find who are affected by this,” she added.
Dr. Chute sees patients with vaginal dryness in her office every day and often jokes with her patients about it. “It’s not like you’re out to dinner with friends and talk about vaginal dryness.”
“I like to educate women about vaginal dryness because it can really affect quality of life,” she said. “Generally, somewhere around 85 to 90 percent of women are affected by this after age 40. I think a lot of women deal with these symptoms for years and don’t realize there are options that work very well.”
Symptoms and Treatment
For some women, symptoms are straightforward, such as dryness or irritation. She said these symptoms are very noticeable and easy to explain. But other problems are also associated with vaginal dryness.
When women lose estrogen after menopause and the skin gets thin, the urethra, which empties the bladder, also gets thin, explained Dr. Chute. This can increase symptoms of a bladder infection, like urinary frequency and irritation with voiding, and it also increases the likelihood of having a urinary tract infection.
“Sometimes women are referred to me who have had recurrent bladder infections, and we treat them with medication that can help minimize those infections in the future,” she said. Typically, water-based lubricants are the first line of treatment. There are two types of water-based lubricants. Daily moisturizer applied to the skin can ease symptoms of irritation. Lubricants typically used for intercourse are the second type.
Painful intercourse, she noted, is a major symptom of vaginal dryness. “After menopause, women may start to feel some discomfort with intercourse, and it may become an uncomfortable or possibly physically traumatic experience. Then women stop pursuing intercourse, which can be OK in some relationships or not OK in some relationships.”
“When I have a patient who has had painful intercourse or recurrent bladder infections, the next line of treatment typically is vaginal estrogen. These are prescribed medications and typically come in three forms—creams, tablets, or rings—that are placed in the vagina.”
Most women who hear the word “estrogen” become concerned about the potential risk. But Dr. Chute said there is a big difference between local vaginal estrogen and systemic hormone-based therapy estrogen.
“Vaginal estrogen and estrogen used in hormone replacement therapy are two very separate categories of medications,” she said. “I often counsel patients and differentiate between the two types of estrogen when I prescribe these. Vaginal estrogen almost always changes women’s quality of life positively.”
She reminds patients that if they stop using the prescribed vaginal creams, the dryness will return. It’s also helpful to start using the creams as soon as possible, before the skin becomes thin.
“I have seen so many patients of all ages have such a positive experience after using vaginal creams,” she assured.
Embarrassment keeps people from sharing many things. As Dr. Chute explained, “I don’t think women are sharing the physical symptoms associated with vaginal dryness with their friends. That’s what is so nice about my job as a GYN. I’m in an intimate setting with a woman who hopefully feels comfortable speaking with me. I often ask questions that open the door to conversations. ‘Do you have signs of a bladder infection?’ ‘How is intercourse?’ 'Have you noticed a change?’ ‘Do you feel dry?’ I find patients feel comfortable in that setting and are really excited to learn there are a lot of options that can help them feel better.
“I feel like if you can’t tell it to your doctor—someone who has to keep your utmost secrets secret—who can you tell it to?”
