Medicines for Vaginal dryness

What it is

Vaginal dryness is a common and often under-reported problem in which the tissues of the vagina become thinner, drier and less elastic, leading to dryness, soreness, itching, irritation and discomfort, including pain or discomfort during sex. It happens because these tissues depend on the hormone oestrogen to stay supple and well lubricated, so anything that lowers oestrogen tends to cause dryness. By far the most common cause is the menopause, when oestrogen levels fall — this is sometimes called vaginal atrophy or part of the genitourinary syndrome of the menopause — but dryness can also occur while breastfeeding, with certain medicines (such as some used in breast cancer treatment), after some cancer treatments, or with conditions affecting the area. As well as the vaginal symptoms, low oestrogen in this area can cause urinary symptoms such as needing to pass urine more often or recurrent urinary infections. Although many women feel embarrassed to raise it, vaginal dryness is extremely common, it is not something you simply have to put up with, and there are simple, effective treatments — so it is well worth mentioning to a GP, nurse or pharmacist.

How it is treated

Vaginal dryness can be managed in steps, often starting with measures available without prescription. Vaginal moisturisers are used regularly, every few days, to rehydrate the tissues and give ongoing relief, while lubricants are used at the time of sex to ease discomfort and friction; the two are different and can be used together. Avoiding perfumed soaps, washes and other products that irritate the area also helps. Where these are not enough, the most effective treatment is local (vaginal) oestrogen, given as a cream, pessary, gel or vaginal ring. This is a low-dose treatment that acts mainly on the vaginal tissues to restore their thickness and natural lubrication, with very little absorbed into the rest of the body. Because of this, it is generally suitable for long-term use and can be an option for many women who cannot take, or choose not to take, systemic hormone replacement therapy (HRT). For women who also have other menopausal symptoms such as hot flushes, systemic HRT can help the whole picture, and local oestrogen can be added if vaginal symptoms persist. It is important to know that any bleeding after the menopause must always be checked before assuming it is due to dryness.