Before we get into vaginal dryness and what is happening and how to manage it, let’s do a quick recap on some basic anatomy.
The vagina is the muscular passage that connects your uterus to the vulva. The vulva is the external genital area and includes the opening to the vagina and urethra (the exit point of the urinary tract), the pubic mound, labia and clitoris.
The tissue and muscles in the vulva and vagina are heavily impacted by oestrogen – and as oestrogen levels fluctuate and eventually decline during the menopause transition, this impacts the health and structure of the tissues in this area. This can lead to a number of symptoms – and each woman may have a different experience, depending on her unique body.
Dryness: Oestrogen keeps the tissues in this area moist, flexible and healthy. As oestrogen levels decline, this can lead to the vaginal walls becoming thinner and more fragile which may cause dryness, itching and irritation. This can be quite painful, and may even cause bleeding when the delicate skin tears during penetrative sex. The external vulva area may even become sensitive to wiping after urination.
Elasticity: The flexibility of the vagina and vulva may also decline during menopause, resulting in painful sex.
Increased risk of infection: As the vagina and vulva loose their natural moisture, this can change the balance of the natural bacteria – make the area more susceptible to infections like yeast (thrush) or change the natural discharge (becoming more or less). You may also experience burning while urinating – and could become more susceptible to urinary infections.
General increases in discomfort or infections can both lead women to feeling less inclined towards sex. And when combined with a lower libido brought on by other menopause-related factors, this can lead to women withdrawing from sex altogether. Unfortunately vaginal symptoms – unlike many other menopause-related symptoms – don’t get better by themselves or over time. They require specific interventions to deal with the underlying causes.
You do not need to suffer in silence! There is help available. In addition to the tips provided below, consider speaking to your healthcare provider who can help you understand if medication may be the right solution for you.