Dr Caitlin: The Symptoms And Treatment Of Vaginal Dryness

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Dr Caitlin O’Connor of Tralee Medical Centre in St Brendan’s Park on vaginal dryness…

It’s a problem that can affect any woman; although after the menopause it is very common, affecting over half of post-menopausal women.

The symptoms may include dryness, discomfort during sex and urinary symptoms, but these can usually be eased with treatment.

The skin and tissues around the vagina are kept supple and moist by fluids and mucus that are made by glands at the neck of the womb.

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Oestrogen (the female hormone) affects these glands. Oestrogen also affects the tissues in and around the vagina, causing the lining of the vagina to be thicker and more elastic.

After the menopause (the ‘change’) the ovaries make less oestrogen. This lack of oestrogen can lead to a thinning of the tissues around the vaginal area, and a reduction in the number of the small glands that make mucus.

How common is it?

After the menopause about one in every two women experience some symptoms — with the frequency of the symptoms increasing as women move beyond the menopause.

What are the symptoms?

The changes described earlier may occur, but without causing any symptoms or discomfort. However, some of the following symptoms may develop in some women. It is a common (and usually treatable) cause of the following problems, but these can also be caused by other medical conditions.

• Pain when you have sex

• Discomfort – if the vulva or vagina is sore or inflammed

• Vaginal discharge — a white or yellow discharge may occur.

• Itching — the skin around the vagina is more sensitive and more likely to itch.

• Urinary problems — symptoms that may occur include an urgency to get to the toilet and recurring urinary infections.

What treatments are available?

Not all women have all of the above symptoms, so treatment may depend on which symptoms are the most troublesome. Because the problem is mainly due to a lack of oestrogen, it can be helped by replacing the oestrogen in the tissues.

Hormone Replacement Therapy (HRT)

This means taking oestrogen in the form of tablet, gel, implant or patches. This may be the best treatment for relieving the symptoms, but some women don’t like the idea of taking HRT. There are advantages and disadvantages of using HRT. Talk to your GP for more information.

Oestrogen creams

Sometimes a cream, pessary or vaginal ring containing oestrogen is prescribed. This restores oestrogen to the vagina and surrounding tissues without giving oestrogen to the whole body.

Repeated courses of treatment are often necessary. It is important to follow the instructions about the amount of cream to use.

Vaginal moisturisers

If vaginal dryness is the only problem, or hormone creams are not recommended because of how they might interact with medication for other medical problems, long—lasting vaginal moisturisers may help.

There are various products which are specifically designed to help the problem of vaginal dryness. You can buy these from the pharmacy and your pharmacist can advise you which might be most suitable for you.

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