The Quiet Pain of Vaginal Dryness: Causes, Symptoms and Treatment

Hey, your epic Aunt Julie is dropping in this month with another women's health subject to bust the taboo about. Vaginal dryness, you may have heard about it, you may not have. Either way, anyone who has experienced vaginal dryness will know just how painful, uncomfortable, and difficult it can be to live with.

What is Vaginal Dryness? 

Vaginal dryness can be caused by several things such as lack of arousal, stress, certain medications, pregnancy or breastfeeding, some medical treatments, and hormonal changes such as the fall in oestrogen associated with menopause, which can also cause vaginal wall thinning and reduced lubrication. When your natural moisturiser decides to go on a little holiday with no warning, it can be quite a surprise to find that normal things like sitting down, wearing underwear or having sex are much more painful than you remember. 

Around 17% of women experience vaginal dryness before they even hit perimenopause,  while almost half of post-menopausal women experience it. Now that is a staggering statistic. 

The Function of Vaginal Discharge 

There are a number of vaginal fluids that are created by the body for different purposes. 

1. Cervical mucus changes throughout the menstrual cycle and becomes thinner and more slippery around ovulation, helping sperm move through the cervix and reproductive tract.

2. Arousal fluid occurs during sexual arousal, partly as a result of increased blood flow to the genital tissues and fluid passing through the vaginal walls, which all contribute to vaginal lubrication.

3. Vaginal discharge is a general term for fluid or mucus released from the vagina and cervix. Its amount, colour and consistency can naturally change throughout the menstrual cycle and at different stages of life.

Stigma Around Discharge 

I think many of us have experienced the slight coyness when we are swapping our knickers for our swimsuit, getting undressed in front of a partner or even when intimacy is in full swing. The feeling in the back of our minds that whatever happens, don’t let them see the discharge in our knickers! 

And yet, why? Is there a rule that decrees that female bodily functions are to be disparaged, to be hidden away, to be brushed under the rug? 

I am sure that if you ask yourself, really ask yourself, ‘What is wrong with people seeing that my body is doing just what it is supposed to?’ you may find you don’t have a complete answer. 

This can also extend to having less vaginal discharge as we age, with similar connotations of privacy and secrecy. While women may hide the fact that they have discharge in the first place, they may also feel embarrassed to talk about having very little natural lubrication and how it can actually be quite a painful experience. Pair this with painful sex, which could potentially include tearing due to thinning vaginal skin, and I do wonder if it has more to do with the taboo of sex than the issue of dryness itself. 

Treatment for Vaginal Dryness

If you are experiencing painful dryness (particularly during sexual activity,) there are a few things that can help. 

• Allow longer for foreplay to give your body time to respond to arousal.

• Try a water-based lubricant. Silicone-based lubricants are another option and tend to last longer, which some people find helpful when dryness is persistent.

• Vaginal moisturisers can be used regularly to help manage ongoing vaginal dryness,  rather than only during sexual activity. For external vulval dryness or irritation, use only products specifically designed for the vulval area.

• Reduced friction will go a long way when your skin is feeling sensitive. Wear natural long filament fiber knickers, made with fabrics like silk or pima cotton, and avoid tight fitted clothing. 

To look for a longer-term and root-cause solution, here are some areas to start with:

• Stress - When your body is existing in fight or flight mode, your blood is naturally re-directed to core organs, meaning that it can decrease vaginal lubrication as well as reduce libido. 

• Review medication - Some medication can worsen vaginal dryness. Continue with your usual prescription and ask to speak to your doctor for a review. 

• Check your hormone health -  If you're experiencing vaginal dryness during or after pregnancy, while breastfeeding, or during perimenopause or menopause, speak to a healthcare professional about possible causes and treatment options. 

• Ensure a balanced diet - Foods containing phytoestrogen (plant estrogen) probiotics, vitamin A and healthy fats will all contribute to a healthy and well-oiled body. 

• Prescriptions - For menopause-related symptoms, your GP may also recommend vaginal oestrogen, a local form of HRT that can improve dryness, irritation and discomfort.

If you are worried about a potential infection due to pain, burning, bleeding after intercourse or other symptoms, you can read more about how to spot an infection  here. 

When to See a Doctor About Vaginal Dryness

Vaginal dryness is common, but that doesn't mean you have to simply put up with it.

Speak to your GP if dryness is persistent, affecting your everyday life or making sex painful. You should also get checked if you experience unusual discharge, bleeding after sex, bleeding between periods, bleeding after menopause, or recurrent urinary symptoms or  UTIs.

Don't be embarrassed to bring it up. Vaginal dryness is a real health issue, and getting the right advice can make a huge difference.

 Is Vaginal Dryness Normal?

To conclude, vaginal dryness is something that many of us have or will experience in our lifetime. The stigma around using lubricants, medication, and taking things a little slower is an opportunity for connection, not for bulldozing on through. 

Don’t we deserve some tender connection? Whether that is with our friends as we discuss the intricacies of what has and hasn’t worked for us, or with a partner who needs a gentle reminder to slow down and cherish the moment. 

Vaginal dryness is common, especially during perimenopause and menopause, but that doesn't mean you have to put up with pain or discomfort. There are treatments and lifestyle approaches that can help. 

I hope this serves as a reminder that you are in the driver seat of your own body; you can put the breaks on whenever you want and speak out about your experiences.

With bountiful boldness, Aunt Julie x