- Vaginal Dryness and Vaginal Atrophy Center
- Take the Menopause Quiz
- Menopause and Perimenopause Slideshow
- Osteoporosis Slideshow Pictures
- Patient Comments: Vaginal Dryness - Causes
- Patient Comments: Vaginal Dryness - Symptoms
- Patient Comments: Vaginal Dryness - Treatment
- Find a local Obstetrician-Gynecologist in your town
- Vaginal dryness and vaginal atrophy facts
- What causes vaginal dryness and vaginal atrophy?
- What symptoms can be associated with vaginal dryness and vaginal atrophy?
- How is vaginal dryness and vaginal atrophy diagnosed?
- What treatments are available for vaginal dryness and vaginal atrophy?
- What is the outlook for vaginal dryness and vaginal atrophy?
Vaginal dryness and vaginal atrophy facts
- Vaginal atrophy is the medical term that refers to the thinning of the wall of the vagina that occurs during the menopause (the time after menstrual periods have ceased) in women.
- Vaginal atrophy occurs due to falling estrogen levels.
- Vaginal atrophy may be associated with vaginal dryness, itching, irritation, and/or pain during sexual intercourse.
- Hormone therapy can be effective in treating vaginal atrophy and other menopausal symptoms, but hormone therapy carries its own risks.
- Local vaginal hormone creams or vaginal lubricants are alternatives to systemic hormone therapy.
What causes vaginal dryness and vaginal atrophy?
Vaginal atrophy is the medical term that refers to the thinning of the wall of the vagina that occurs during menopause (the time when menstrual periods have ceased) in women. Prior to menopause, the vaginal lining appears plump, bright red, and moist. As estrogen levels decline, the lining of the vagina becomes thinner, drier, light pink to bluish in color, and less elastic. This is a normal change that is noticed by many perimenopausal and postmenopausal women.
Estrogen levels begin to fall as the menopause approaches. Estrogens are mainly produced by the ovaries. Estrogens control the development of female body characteristics such as the breasts, body shape, and body hair. Estrogens also play a significant role in the regulation of the menstrual cycle and pregnancy.
Most women reach menopause between the ages of 45 and 55, but it can occur earlier or later in life. The menopause average age is 51 years old. Every woman is different, and there is no definitive way to predict when an individual woman will enter menopause. Also, women in the menopausal transition experience symptoms with varying degrees of severity. Not all perimenopausal and postmenopausal women will have the same symptoms or experience the same levels of severity.
Quick GuideFemale Sexual Dysfunction: Treatment for Women's Sexual Disorders
What symptoms can be associated with vaginal dryness and vaginal atrophy?
Other vaginal symptoms that are commonly associated with vaginal atrophy include vaginal dryness, itching, irritation, and/or pain with sexual intercourse (known as dyspareunia). The vaginal changes also lead to an increased risk of vaginal infections.
In addition to the vaginal symptoms, women may experience other symptoms of the menopausal transition. Hot flashes, night sweats, mood changes, fatigue, urinary tract infections, urinary incontinence, acne, memory problems, and unwanted hair growth.
How is vaginal dryness and vaginal atrophy diagnosed?
Vaginal symptoms such as itching, dryness, or pain with sexual intercourse is typically sufficient to assume that a women is suffering from vaginal dryness and vaginal atrophy if she is experiencing other symptoms consistent with the menopausal transition. Of course, a careful physical examination, including a pelvic examination, is necessary to rule out other conditions (such as infections) that may be causing vaginal symptoms.
There are no specific tests available to determine whether the vaginal wall has become thinner or less elastic.
What treatments are available for vaginal dryness and vaginal atrophy?
Vaginal dryness and atrophy do not need to be treated unless they cause symptoms or discomfort. Women who experience symptoms have several treatment options.
Hormone therapy (HT) is effective in treating vaginal dryness/vaginal atrophy. HT has also been referred to as hormone replacement therapy (HRT) or postmenopausal hormone therapy (PHT). HT has been shown to effectively reduce vaginal dryness as well as help control hot flashes associated with menopause.
However, HT is not without its risks. Long-term studies (the NIH-sponsored Women's Health Initiative, or WHI) of women who took oral combined hormone therapy containing both estrogen and progesterone showed that these women had an increased risk for heart attack, stroke, and breast cancer when compared with women who did not receive it.
Women taking oral estrogen alone had an increased risk for stroke, but not for heart attack or breast cancer. Estrogen therapy alone, however, is associated with an increased risk of developing endometrial cancer (cancer of the lining of the uterus) in postmenopausal women who have not had their uterus surgically removed.
HT may be administered in pill form or transdermally (patches or sprays from which the medication is absorbed through the skin). Transdermal estogens enter the circulation directly, where oral estrogen products must first pass through the liver from the stomach. Since transdermal hormone products do not have effects on the liver, this route of administration has become the preferred form for most women. A number of preparations are available for oral and transdermal forms of HT, varying in the both type and amount of hormones in the products.
So-called "bioidentical" hormone therapy for perimenopausal women has been a source of much attention in recent years. Bioidentical hormone preparations are hormones with the same chemical formula as those made naturally in the body but which are produced in a laboratory by altering compounds derived from naturally-occurring plant products. While some of these preparations are U.S. FDA-approved and manufactured by drug companies, others are made at special pharmacies called compounding pharmacies, which make the preparations on a case-by-case basis for each patient. Since individually compounded products cannot be standardized, these individual preparations are not regulated by the FDA. There is no evidence that bioidentical preparations provide superior symptom relief. Studies to establish the long-term safety and effectiveness of these products have not yet been carried out.
No matter what form of therapy is used, the decision about hormone therapy should take into account the inherent risks and benefits of the treatment along with each woman's own medical history and the severity of her symptoms. Current recommendations state that if hormone therapy is used, it should be used at the smallest effective dose for the shortest possible time.
There are also local, topical (meaning applied directly to the vagina) low-dose hormonal treatments for the symptoms of vaginal dryness and vaginal atrophy. Local treatments include the vaginal estrogen ring, vaginal estrogen cream, or vaginal estrogen tablets. Local (vaginal) estrogen treatments can be very effective in reducing vaginal dryness while having a minimal effect on other tissues in the body.
There is also now a product for vaginal dryness that consists of a daily pill which contains a selective estrogen receptor modulator (SERM). These are theoretically safer than estrogens and can be alternative for some patients.
Vaginal moisturizing agents such as creams or lotions (for example, K-Y Silk-E Vaginal Moisturizer or KY Liquibeads Vaginal Moisturizer) as well as the use of lubricants during sexual intercourse are non-hormonal options for managing the discomfort of vaginal dryness. A longer acting moisturizer called Replens is also available over the counter.
Applying Betadine topically on the outer vaginal area, and soaking in a sitz bath or soaking in a bathtub of warm water may be helpful for relieving symptoms of burning and vaginal pain after intercourse.
What is the outlook for vaginal dryness and vaginal atrophy?
Vaginal dryness and vaginal atrophy are common complaints in postmenopausal women. While these conditions do not produce serious consequences, they are a source of significant discomfort for many women. Hormone treatments are available that are very effective in reducing vaginal dryness, but whether or not to use hormone therapy is an individual decision that must consider the inherent risks and benefits of the treatment along with each woman's own medical history. Women with only mild symptoms may experience relief by using vaginal moisturizing agents and/or lubricants during sexual intercourse.
Daily Health News
Women's Health Resources
Subscribe to MedicineNet's Women's Health Newsletter
Rossouw JE; Anderson GL; Prentice RL et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JA
Utian WH; Archer DF; Bachmann GA, et al. Estrogen and progestogen use in postmenopausal women: July 2008 position statement of The North American Menopause Society. Menopause. 2008 Jul-Aug;15(4 Pt 1):584-602.
Vaginal Dryness - Causes
If known, what was the cause of your vaginal dryness or atrophy?Post View 5 Comments
Vaginal Dryness - Symptoms
Discuss the other symptoms associated with your vaginal dryness or vaginal atrophy.Post View 3 Comments
Vaginal Dryness - Treatment
What kinds of treatment have you tried for your vaginal dryness or atrophy?Post View 3 Comments
Top Vaginal Dryness and Vaginal Atrophy Related Articles
9 Signs of PerimenopausePerimenopause occurs before menopause as estrogen levels begin to change. This can cause menopause like symptoms such as hot flashes, night sweats, heavy bleeding, weight gain, vaginal dryness, and changes to libido. Pregnancy is still possibly during perimenopause.
Bacterial Vaginosis (Causes, Symptoms, Treatment)
Bacterial vaginosis is an abnormal vaginal condition with signs and symptoms of vaginal discharge, vaginal odor, and vaginal pain.
Bacterial vaginosis results from an overgrowth of normal bacteria in the vagina. Although it may cause some disturbing symptoms (discharge and odor), it is not dangerous and cannot be passed by sex. Diagnosis becomes important to exclude serious infections like gonorrhea and Chlamydia. Many treatment options are available such as oral antibiotics and vaginal gels.
13 Hormone Imbalance Symptoms and SignsHormone imbalance involves changes in estrogen, progesterone, and other hormone levels. Hormonal imbalance may cause symptoms like weight gain, hot flashes, fatigue, and acne. Hormonal changes happen in menopause and at other times. Women with hormone imbalances can seek treatment from medications like triptan and SSRIs.
Hormone TherapyEstrogen therapy, estrogen/progestin therapy, and hormone therapy are terms that refer to the administration of estrogen or estrogen/progestin for the purpose of suppressing hot flashes. Side effects of hormone therapy include:
- breast pain,
- blood clots,
- breast cancer,
- heart disease,
- abnormal vaginal bleeding,
- and uterine cancer.
Kidney InfectionKidney infection (pyelonephritis) usually is caused from bacteria that have spread from the bladder from a UTI (urinary tract infection), poor hygiene, sexual intercourse, pregnancy, catheter, cystoscope exam, surgery, kidney stones, or prostate enlargement. Symptoms of kidney infection include: back pain, frequent urination, pain during urination, fever, and or pus or blood in the urine. Kidney infection is usually treated with antibiotics.
MenopauseMenopause is the time in a woman's life when menstrual periods permanently stop, also called the "change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Menopause and SexMenopause is often associated with a change in sexual functioning. Loss of estrogen, bladder control issues, anxiety, stress, health concerns, medications, and sleep disturbances often result in a decrease in libido. Though there are currently no good drugs for treating sexual problems in women, there are ways to increase intimacy with a partner and treat vaginal dryness.
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. The causes of night sweats in most people are not serious, like menopause in women, sleep apnea, medications, alcohol withdrawal, and thyroid problems. However, more serious diseases like cancer and HIV also can cause night sweats. Your doctor will treat your night sweats depending upon the cause.
You may experience other signs and symptoms that are associated with night sweats, which depend upon the cause, but may include:
- Fever, shaking, and chills with a fever caused by an infection like the flu or pneumonia.
- Unexplained weight loss due to lymphoma.
- Women in perimenopause or menopause may also have vaginal dryness, mood swings, and hot flashes during the day.
- Low blood sugar in people with diabetes.
Other causes of night sweats include:
- Medications like NSAIDs (aspirin, acetaminophen, ibuprofen (Motrin, Advil), and naproxen (Aleve, Naprosyn), antidepressants, sildenafil (Viagra), and abuse of prescription or illegal drugs and drug withdrawal.
- Hormone disorders like pheochromocytoma and carcinoid syndrome
- Idiopathic hyperhidrosis
- Infections like endocarditis, AIDs, and abscesses.
- Alcoholism and alcohol withdrawal
- Drug abuse, addiction, and withdrawal
A doctor or other health care professional can treat your night sweats after the cause has been diagnosed.
PerimenopausePerimenopause is the time in a woman's life when she is approaching menopause. During this time a woman starts to develop symptoms of declining estrogen levels that may include mood swings, painful sex, night sweats, hot flashes, and weight gain. Every adult woman eventually will experience perimenopause.
Sexual Health OverviewSexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.
Urinary IncontinenceThere are many types of urinary incontinence (UI), which is the accidental leakage of urine. These types include stress incontinence, urge incontinence, and overflow incontinence. Urinary incontinence in men may be caused by prostate or nerve problems. Treatment depends upon the type and severity of the UI and the patient's lifestyle.
Vagina PictureThe vagina is an elastic, muscular canal with a soft, flexible lining that provides lubrication and sensation. See a picture of the Vagina and learn more about the health topic.
Yeast Infection in Women and Men
Vaginal yeast infections in women are caused by an organism called Candida albicans. Symptoms of a vaginal yeast infection include
- vaginal pain with urination,
- vaginal discharge,
- odor, and
Treatment is generally OTC medications. A man can contract a yeast infection from his female sexual partner. Symptoms of a yeast infection in men include penile itching. Treatment is with oral or topical medication.