Vaginal dryness is a fairly common problem, especially in certain periods of life. Typical of climacteric and of the years following menopause, the dryness of the vagina is very often a brake on one's sexual serenity, an obstacle - fortunately - anything but insurmountable.
Symptoms
The signs and symptoms that accompany vaginal dryness typically include itching and burning at the opening of the vagina and its lower third, associated with pain and sometimes minor bleeding during sexual intercourse.
The causes of vaginal dryness
In gynecology, vaginal dryness is typically linked to a lack of estrogen, a female hormone essential for fertility and good vaginal health. With their action, estrogens maintain the local pH at slightly acid values (around 4.5), stimulate cervical secretions and maintain normal tissue elasticity. Estrogen deficiency also causes unfavorable changes in the bladder, urethra and all structures involved in urine elimination. For this reason, vaginal dryness can be accompanied by micturition disorders and a greater incidence of cystitis.
The estrogenic levels typically decrease in menopause and in the years preceding it, but also due to cigarette smoking, after surgical removal of the ovaries, during lactation and as a side effect of anticancer therapies (such as chemotherapeutic, hormonal or radiant) . Some anti-estrogenic drugs used to fight breast cancer, such as arimidex, can for example cause vaginal dryness, which is also common among those who take certain medications against allergies, colds or depression.
Vaginal dryness can be caused by insufficient sexual excitement, due to various psychological or relational causes.
The excessive and unjustified recourse to vaginal lavages contributes to altering the normal ecosystem of the vagina, promoting the onset of inflammatory phenomena with a feeling of dryness and itching. The same can be said for various types of deodorants, perfumes and sprays used for intimate hygiene.
Vaginal dryness is a typical symptom of Sjogren's syndrome, an autoimmune disease in which dryness also affects the eyes, airways and mouth.
Finally, even periods characterized by severe psycho-physical stress, such as a particularly restrictive diet, subjected to intense physical activity or major social, family, work, sentimental and so on problems, are typically accompanied by vaginal dryness. The same conditions, not surprisingly, often become responsible for irregular and amenorrhea cycles; the reason is easy to say: such intense stressful stimuli create a temporary and reversible block at the hypothalamic level, "turning off" the reproductive attitude and with it the maturation of the follicles.
Available treatments
See also: drugs for the treatment of vaginal dryness
Since there are several possible causes of vaginal dryness, there are just as many potential treatments. For this reason it is important not to resign to live with this annoying disorder, which can be solved in complete serenity and safety with the help of the gynecologist.
Vaginal dryness can be effectively treated with vaginal estrogen therapy, a safe remedy that requires a prescription. Instead of intervening with the classic hormone replacement therapy, specific estrogen-based medicines can be applied directly into the vagina; in this way the hormonal amount absorbed is minimized (<2%) and testosterone levels, which are very important for sexual desire, are not negatively affected. Vaginal estrogen therapy can be undertaken in various forms; it is possible, for example, to use a cream with the aid of a special device, insert rings to be replaced about every three months or apply a small capsule in the vagina two or three times a week. Local estrogen therapy is generally well accepted, helps the vagina to regain optimal lubrication, normalizes the bladder and the vaginal ecosystem (reduces the risk of vaginitis), and lacks the side effects typically associated with TOS (for example, does not increase the risk of breast cancer). However, hormone replacement therapy may be necessary when vaginal dryness is accompanied by other typical menopausal disorders, such as intense or moderately severe flushing.
To resolve the problem of vaginal dryness during childbearing age, contraceptive pills can help if contraceptive needs arise. Sometimes, however, it is the same pills, especially the ultralight ones, that diminish intimate lubrication; even in this case it is possible to overcome dryness by applying the aforementioned estrogen-based vaginal products.
In the pharmacy special lubricants can be found to be applied directly on the vaginal opening or distributed on the penis of the partner; these must be strictly water based (the oily ones, in addition to being potentially harmful to the latex of the condom, can upset the normal vaginal ecosystem). There are also moisturizing preparations capable of restoring normal lubrication of the environment for two or three days.
Among the supplements and natural remedies indicated in the presence of vaginal dryness stand out soy and its derivatives (miso, tofu, tempeh, soy milk), Cimicifuga racemosa, isoflavones and other phytoestrogens (generally isolated from the same soy or from the clover red). The latter mimic the activity of endogenous estrogens but with a markedly lower intensity of action; for this reason they are traditionally recommended not only to improve vaginal dryness, but also to resolve other typical menopausal symptoms. As far as nutrition is concerned, it is advisable to avoid drastic diets, maintain a high fluid intake and meet the need for fat, including essential oils (cholesterol, present exclusively in animal fats, is essential for the synthesis of sex hormones ).
Finally, to prevent vaginal dryness, it is advisable to maintain adequate intimate hygiene (no vaginal lavage, excessive cleansing, tight pants or aggressive soaps; simply warm water and a little clinically tested detergent at pH 3.5-5.5 on the external genitals ).
