Introduction
The natural phase in a woman’s life that typically starts in her 40s, leading up to menopause, is called perimenopause. It is a period of transitional hormonal changes that can and do affect a woman’s body in many ways. One of those ways is the experience of vaginal dryness, which the National Institutes of Health says can and does lead to pain during intercourse, discomfort, and even emotional distress. It’s a conversation that the NIH says not enough women are having, even though at least 40 percent will experience this symptomatic phase of perimenopause.
Understanding Perimenopause
The time just before menopause is called perimenopause. In this phase, a woman’s body is in transition and doesn’t always behave the way it used to. Hormones fluctuate, and the level of estrogen begins a slow decline, leading to a number of physical and emotional symptoms. This phase can last several years and is quite variable in the number of years it lasts among different individuals. Most of the symptoms are pretty well known and discussed.
Usual Symptoms
Of course, some women have more severe symptoms than others or have a different mix of symptoms than is usual.
What Causes Vaginal Dryness?
Vaginal dryness during perimenopause largely results from lower levels of estrogen. Estrogen plays a vital role in sustaining the health of vaginal tissue, keeping it lubricated and elastic. When estrogen levels drop, the vaginal walls can become thinner and less elastic—leading to dryness. Other factors that can contribute to vaginal dryness include:
- Stress: Excessive stress can disrupt the balance of hormones in the body, which can sometimes lead to dryness of the vagina.
- Medications: Some medications, like antihistamines and certain antidepressants, list vaginal dryness as a possible side effect.
- Medical Conditions: Diseases like diabetes, various autoimmune disorders, and certain thyroid problems can have negative effects on vaginal moisture.
- Lifestyle Factors: The combination of smoking, drinking too much alcohol, and not exercising enough is a sure way to increase your chances for dryness.
Symptoms of Vaginal Dryness
Ways in which vaginal dryness can manifest include: - Pruritus or burning sensation: A frequent symptom that can lead to considerable discomfort.
- Dyspareunia: This can create a “negative cycle” of avoidance and anxiety concerning sexual activity.
- Urinary frequency or urgency: Some women may “sense” changes in bladder function.
- Discomfort during physical activities: SAS patients have reported that foundations of discomfort during exercise or even prolonged sitting have become a concern for some.
Management Strategies
Vaginal dryness in perimenopause: management strategies
Managing vaginal dryness during perimenopause can take a few different forms.
- Lifestyle changes: diet, exercise, and hydration.
- OTC products: lubricants and moisturizers.
- Medical options: hormones and non-hormonal prescriptions.
Here are a few to consider: - Hydration
Maintaining adequate hydration is a must for good health overall and vaginal health in particular. Water (and lots of it) helps keep the moisture in your body where it belongs. Aim for at least 8-10 glasses of water a day, and in addition, load up on high-water-content foods like fruits and vegetables. - Dietary Changes
A diet that is rich in phytoestrogens and balanced can help counter some of the effects that lead to vaginal dryness.
Phytoestrogens are compounds found in plants that can mimic estrogen in the body. Some foods are particularly rich in these compounds. Eating more of these foods and staying within the healthy ranges of fats, carbohydrates, and proteins can help keep your hormones in balance—not just your estrogen levels, but all your hormones.
Here’s a list of some of those foods:
- Soy products (such as tofu and tempeh) and foods (such as soy milk).
- Flaxseeds (and other seeds).
- Whole grains.
- Moderately fatty foods (like avocados and nuts).
- Extra virgin olive oil.
- Regular Exercise
Improving circulation and overall hormonal balance can occur because of physical activity. Doing regular exercise, like walking, swimming, or yoga, might help reduce stress and boost one’s mood, which could then enhance the health of one’s vagina. - Lubricants and Moisturizers
Relief can be gained during sexual activity by using over-the-counter, water-, or silicone-based lubricants. For more prolonged relief, and to maintain moisture in the vaginal tissues, consider using a vaginal moisturizer that can be applied more regularly. These products are accessible without a prescription and can better the comfort quotient significantly. - Hormonal Treatments
For some women, a suitable option may be hormone replacement therapy (HRT). HRT can help to alleviate many of the symptoms of perimenopause, including dryness of the vagina. Localized estrogen therapy, such as vaginal creams, rings, or tablets, can deliver estrogen directly to the vaginal area with fewer effects felt throughout the body.
It is vital to consult a healthcare provider to discuss the pros and cons of using HRT. - Alternative Therapies
Relief for some women comes from using alternative therapies like acupuncture, herbal supplements, or essential oils. But it is very important to be careful with these options and to talk with a healthcare provider before beginning any new treatments. - Communication with Partners
Talking openly with your sexual partners about vaginal dryness can help reduce both of your anxieties and make your intimate moments even better. When you share the things that you feel and think about not just to mention some areas that could stand some improvement but also to highlight what you enjoy and find pleasurable, it sets up a really great foundation for deepening your intimacy and possibly even your friendship if that is also involved in your intimate relationship. - Regular Gynecological Check-ups
Consistent consultations with a gynecologist can serve to watch over the transitions occurring in not only the health of the vagina but also the general fertility health of the patient. Any patient who experiences, even momentarily, vaginal dryness or discomfort that seems out of the ordinary should speak with their healthcare provider. There are a number of reasons a person might experience such symptoms, and a healthcare provider can offer the best individualized assessment.
Emotional Impact of Vaginal Dryness
Vaginal dryness can have emotional effects, touching self-esteem and relationships. It is necessary to acknowledge these feelings and seek support if they are felt. Support groups and therapists can provide a space to safely share concerns and experiences about this issue. Talking helps problem-solve in a relationship and can also prevent a downward spiral into low self-esteem.
Conclusion
Vaginal dryness during perimenopause is a widespread problem that many women contend with. Grasping the reasons and signs is the initial move toward managing it effectively. The women I know who managed this phase of life successfully adopted a comprehensive approach that included lifestyle changes, products from the pharmacy, and necessary medical interventions.
This isn’t a condition that anyone should have to suffer in silence through. Partners and health care providers both need to be part of the team helping women navigate the challenges of perimenopause.