This is often confused with insufficient vaginal lubrication, something which is triggered by sexual desire.
Intimate dryness however, is initially experienced as local discomfort throughout the day, and sometimes irritation. The mucous membranes of the vulva and/or vagina are pale, thinner and more fragile; they have lost their suppleness and elasticity. In some cases, fissures can even occur.
In medical jargon, particularly during smear tests, the term “atrophy” is used.
In the long term, it causes discomfort and then pain during sexual relations.
Whatever the cause, vulvovaginal dryness can ruin the quality of a person’s sex life.
What causes this intimate dryness?
In most cases the cause is hormonal and linked to an oestrogen deficiency, particularly after the menopause when the ovaries stop secreting hormones. It worsens with age and a lack of sexual relations. Over half of post-menopausal women suffer from it, but few bring it up with their doctor.
In young women, vaginal “atrophy” can occur in certain circumstances such as childbirth and while breastfeeding, but also if a woman has not had a period for more than six months, as has been observed in anorexics. It can also result from taking certain drugs like progestogen, some mini pills, LH-RH analogues and anti oestrogens used for hormone-dependent breast cancer to reduce or stop oestrogen secretion.
This hormone deficiency reduces local blood flow, causes the vaginal mucous to disappear, and stops the secretions of the sebaceous glands of the endocervix and vulva.
The result is a loss of cutaneous collagen, reduced hydration and a gradual loss of mucous membrane elasticity.
Another common cause is vaginal infections of any kind, which irritate and dry out the mucous membranes. Recurrent fungal infections contribute to drying out the vagina, sometimes for long periods of time, to the point where some women think the fungal infection has not been cured and continue to use pessaries indefinitely.
Inappropriate cleansing with an aggressive soap or detergent, frequent douching and the excessive use of tampons, all unbalance the vaginal flora and can even destroy it.
A number of general conditions can also put women at risk of vaginal dryness, such as diabetes, depression and the effects of a gynaecological procedure.
Certain drugs like vitamin A acid used for acne and antidepressants.
How can women maintain good mucosal hydration?
The best way is to maintain regular sexual relations, adopt good intimate hygiene habits and avoid the use of harsh chemicals. Water alone will not solve the problem because it tends to dry out the skin and mucous membranes. Use cleansing products with a moisturizing base that helps preserve the hydrolipidic film.
After menopause, the most effective treatment is HRT which restores moisture, suppleness and elasticity to the mucous membranes. For those who prefer not to take HRT, the use of creams, pessaries or vaginal capsules, hormone based or otherwise, is recommended.
Don’t hesitate to discuss it with your gynaecologist or pharmacist.