Menopausal Vaginal Dryness: What Is It and How Do We Treat It?

Vaginal dryness is very common but because it is not often discussed, it is often underdiagnosed and undertreated. The condition can cause discomfort, often affecting daily activities and overall quality of life. Here, we’re going to talk about the most common vaginal dryness symptoms, what causes it, and how we can help treat it.

What Is Menopausal Vaginal Dryness? Who Does It Affect?

As you may know, our hormone levels fluctuate over our lifetimes. As women age, our bodies tend to produce less oestrogen, which causes many changes within the body. In fact, the drop in oestrogen levels is responsible for many of the symptoms associated with menopause, including vaginal dryness.

The tissues of the vagina produce natural secretions which lubricate and protect the vagina, helping to maintain elasticity. These tissues are particularly sensitive to oestrogen levels, often becoming drier when oestrogen levels are lower. Unfortunately, this can cause soreness, itchiness, and a burning sensation in the vagina and vulva. In addition, lower oestrogen levels can upset the natural balance of bacteria in the vagina. This means that you may be more prone to developing infections like bacterial vaginosis or thrush.

As mentioned, vaginal dryness is often associated with menopause and mostly affects women aged 45 years or more. However, the condition can occur at different stages throughout your lifetime. For instance, it is common to experience vaginal dryness following childbirth and whilst breastfeeding. This is usually temporary and symptoms tend to ease when oestrogen levels return to normal when breastfeeding is stopped.

Similarly, certain medications can influence oestrogen production, thus causing vaginal dryness. Again, this can be temporary as oestrogen levels return to normal once these medications are stopped.

Vaginal dryness can also occur following the surgical removal of the ovaries and can be associated with chemotherapy and radiation therapy of the pelvis.

 

What Are the Most Common Vaginal Dryness Symptoms?

As mentioned above, low oestrogen levels can cause the vagina and vulva to become sore, itchy, and uncomfortable. Therefore, if you are experiencing these sensations at a certain age, it could indicate you are suffering from menopausal vaginal dryness. Equally, suffering from thrush or bacterial vaginosis could also be an indication. The most common indications of vaginal infection are:

  • A change in discharge (you may notice a change in texture or odour)
  • Itchiness or soreness of the skin of the vulva/ vagina
  • Redness or swelling of the skin of the vulva/ vagina
  • Burning pain or discomfort

Decreased oestrogen levels can also cause pelvic floor tissues to thin and weaken, reducing support around the bladder and urethra. This can cause urinary symptoms which may also indicate menopausal vaginal dryness. The main urinary symptoms include:

  • Sudden urgency to get to the bathroom
  • Recurring urinary tract infections
  • Needing to go to the toilet more often

Other key indicators include pain and discomfort during vaginal sex or smear tests. You may also feel some discomfort when moving or working out. The skin around your vagina and vulva is extremely sensitive and when it becomes sore and irritated, it is likely to become itchy. This can lead to scratching, which in turn irritates the skin further and causes itching. This itch/scratch cycle can become distressing and painful, often affecting sleep.

 

How Can We Treat Menopausal Vaginal Dryness?

The good news is that menopausal vaginal dryness is treatable. For many women, additional vaginal oestrogen can help control vaginal symptoms. As low oestrogen levels cause these symptoms, we can replace the hormone to effectively alleviate these symptoms. To do this, our doctors prescribe Vagifem. This is a vaginal tablet (pessary) that contains 10 mcg oestradiol (a type of oestrogen) and it can help stop vaginal dryness.

Vagifem is a type of hormone replacement therapy (HRT) and it is considered to be very safe. This is because it only acts on the localised vaginal tissues and contains a very low dose of hormone. For instance, using 10 mcg Vagifem pessaries for one year is equal to 1 mg oestradiol HRT tablet (one oral oestrogen HRT tablet). It is worth noting, Vagifem will only help with localised vaginal symptoms. It will not help with more generalised menopausal symptoms.

When using Vagifem, the level of oestrogen in your blood is the same as menopausal women who are not using vaginal oestrogen. Therefore, there is a significantly lower risk of side effects such as breast cancer, blood clots, and heart disease, in comparison to other oestrogen treatments (i.e. oral HRT tablets and combined contraceptive pill).

To treat general menopause symptoms, such as hot flashes, you may need to consider other methods of HRT such as gel, patches, or oral tablets. These types of systemic hormonal replacement therapies can help ease general menopause systems as well as helping to prevent vaginal dryness.

 

Using Vagifem as a Vaginal Dryness Treatment

Vagifem is extremely easy to use as each packet will contain detailed instructions and an applicator. Using this applicator, you can easily insert one tablet into the vagina each night, for two weeks. After the initial two weeks, you can then use Vagifem twice weekly.

If you have not used this treatment before, your initial prescription will contain one packet of 24 tablets. After this, your repeat prescription will include 48 tablets that you can use over a 6 month period. If this is your first time using Vagifem, you should complete the first course of treatment and then arrange a review with your doctor.

As menopausal vaginal dryness affects everyone differently, treatment length will differ from patient to patient. It may take between 8 and 12 weeks of treatment to achieve maximum benefits. Some patients may be able to stop taking Vagifem once symptoms have eased, but symptoms often return. If this is the case, Vagifem is suitable for long-term use. We recommend letting any doctor treating you know that you are taking this medication so that your risk can be reassessed if anything changes in your medical history.

Some of the more common side effects of using Vagifem include:

  • Vaginal bleeding/discharge
  • Vaginal discomfort/stinging
  • Stomach pain
  • Headache

If you experience any of the above side effects or you feel your symptoms are not improving, worsening, or changing, you should consult a doctor for a physical examination. Equally, if you develop any unexpected or unexplained vaginal bleeding whilst you are using this medication, you should arrange a consultation with your doctor as a priority.

 

How to Order Vagifem

To order a prescription for Vagifem treatment, simply fill out a brief questionnaire. Once approved, one of our Irish-registered doctors will send your prescription directly to a pharmacy of your choice via secure Healthmail. If you have any questions about menopausal vaginal dryness or would like to discuss treatment in more detail, simply book an online video consultation with one of our doctors. There, we can talk you through the treatment and answer any questions you may have.