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Vaginal Dryness Which Causes Female Sexual Dysfunction
Overview
When your vagina isn't properly lubricated, it can feel itchy and irritated. This condition, vaginal dryness, can make daily activities uncomfortable and sexual intercourse less pleasurable. In fact, during menopause, it's the most common cause of painful sex (dyspareunia).
Vaginal dryness is a common condition that affects women of all ages. It's estimated that 10 percent to 40 percent of women who've reached menopause have symptoms related to vaginal dryness. Some of the signs and symptoms include:
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Dryness
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Itching
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Burning
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Irritation
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A feeling of pressure
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Pain or light bleeding with sex
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A number of self-care measures and medical treatments exist which can help reduce such signs and symptoms.
Causes
A variety of conditions can cause vaginal dryness. Determining the cause is key to helping you find an appropriate solution. Potential causes include:
Decreased estrogen levels
Reduced estrogen levels are the main cause of vaginal dryness. Estrogen, a female hormone, helps keep vaginal tissue healthy by maintaining a normal vaginal acidity level. Acidity creates a natural defense against vaginal and urinary tract infections. But when your estrogen levels decrease, so does this natural defense and the amount of vaginal lubrication. Decreased estrogen amounts can lead to a thinner, less elastic and more fragile vaginal lining.
Reduced estrogen levels are the main cause of vaginal dryness. Estrogen, a female hormone, helps keep vaginal tissue healthy by maintaining a normal vaginal acidity level. Acidity creates a natural defense against vaginal and urinary tract infections. But when your estrogen levels decrease, so does this natural defense and the amount of vaginal lubrication. Decreased estrogen amounts can lead to a thinner, less elastic and more fragile vaginal lining.
Estrogen levels fall for many reasons:
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Menopause and the natural estrogen decline before menopause
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Decreased ovarian function from radiation therapy or chemotherapy
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Surgical removal of ovaries
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Immune disorders
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Loss of estrogen after childbirth and when breast-
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Cigarette smoking
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Decreased sexual activity
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Medications
Some cancer treatment medications, such as tamoxifen (Nolvadex), are designed to interfere with the activity of estrogen and may result in vaginal dryness. Allergy medications, such as antihistamines, can dry out your mucous membranes, including those in the vaginal wall. Certain ulcer, antidepressant and high blood pressure medications also can cause vaginal dryness.
Some cancer treatment medications, such as tamoxifen (Nolvadex), are designed to interfere with the activity of estrogen and may result in vaginal dryness. Allergy medications, such as antihistamines, can dry out your mucous membranes, including those in the vaginal wall. Certain ulcer, antidepressant and high blood pressure medications also can cause vaginal dryness.
Sjogren's syndrome
This is an autoimmune disease in which your immune system attacks healthy tissue. In addition to causing symptoms such as dry eyes and mouth, it can also decrease moisture in your vagina.
This is an autoimmune disease in which your immune system attacks healthy tissue. In addition to causing symptoms such as dry eyes and mouth, it can also decrease moisture in your vagina.
Douching
The process of cleansing your vagina with a liquid preparation (douching) disrupts the normal chemical balance in your vagina and can cause inflammation (vaginitis). This may cause your vagina to feel dry.
The process of cleansing your vagina with a liquid preparation (douching) disrupts the normal chemical balance in your vagina and can cause inflammation (vaginitis). This may cause your vagina to feel dry.
Other conditions
A lack of proper vaginal lubrication also can occur if you have other conditions, which may include:
A lack of proper vaginal lubrication also can occur if you have other conditions, which may include:
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Chronic yeast infection
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Vaginal bacterial infection
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Sexually transmitted diseases, such as trichomoniasis
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Vaginal trauma
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Benign or malignant tumor
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Screening And Diagnosis
Your doctor diagnoses vaginal dryness through a pelvic exam. He or she also may do a microscopic evaluation of your vaginal discharge (wet prep) to assess the estrogen effect and to rule out other causes, such as infection.
Treatment
Estrogen therapy
Since loss of estrogen is the main cause of vaginal dryness, it's not surprising that estrogen therapy is an effective treatment. Options include:
Since loss of estrogen is the main cause of vaginal dryness, it's not surprising that estrogen therapy is an effective treatment. Options include:
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Vaginal estrogen cream (Premarin, Estrace, others). Insert the cream into your vagina with an applicator two or three times a week.
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Vaginal estrogen rings (Estring). You or your doctor inserts the soft, plastic ring into the upper part of your vagina. The ring releases estrogen over a period of 90 days.
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Vaginal estrogen tablets (Vagifem). Use a disposable applicator to place a tablet in your vagina on a regular basis — every day for the first two weeks and then twice a week.
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Skin (transdermal) patches containing estrogen (Estraderm, Climara, others). Apply a patch to your skin and wear it for several days to a week at a time, according to your doctor's instructions. This form of estrogen slightly increases your risk of blood clots, and possibly breast cancer.
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Oral hormone supplements (Premarin, Menest, others). Take these pills daily. Low doses of estrogen-
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All of these methods increase the amount of estrogen in your vagina and relieve vaginal dryness for as long as you use them. Your doctor may not suggest systemic estrogen, such as skin patches and oral hormone supplements, if your only problem is vaginal dryness. However, he or she may suggest you consider such therapy if you're experiencing other symptoms of menopause, such as hot flashes. Talk to your doctor to decide if estrogen treatment is an option and, if so, which type is best for you.
Self Care
If you're uncomfortable from vaginal dryness, certain self-care measures can help:
Lubricants and moisturizers
If vaginal dryness makes sexual intercourse painful, consider an over-the-counter remedy such as:
If vaginal dryness makes sexual intercourse painful, consider an over-
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Lubricants (Astroglide, K-
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Moisturizers (Replens, Lubrin). Vaginal moisturizers help moisturize the vagina for a longer period of time than lubricants do; they may decrease dryness for more than one day with a single application. Moisturizers generally help maintain the acidic environment in the vagina and may help decrease infections.
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Occasional vaginal dryness during intercourse may mean that you aren't sufficiently aroused. Make time to be intimate with your partner and allow your body to become adequately aroused and lubricated. It may help to talk with your partner about what feels good for you. Having intercourse regularly may help promote better vaginal lubrication.
Avoid certain products
Though you may be willing to try just about anything to relieve your discomfort, avoid using these products to treat vaginal dryness, as they may irritate your vagina:
Though you may be willing to try just about anything to relieve your discomfort, avoid using these products to treat vaginal dryness, as they may irritate your vagina:
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Vinegar, yogurt or other douches
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Hand lotions
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Soaps
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Bubble baths
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