Update: This post was originally written in 2010. It has been edited and updated in 2016 to reflect the current positions and opinions of The Perimenopause Blog
Let’s face it. Vaginal dryness is not exactly a topic most women jump on the bandwagon to talk about. Yet, it is a very real and common symptom of perimenopause. And as with all the symptoms we suffer with in perimenopause, vaginal dryness is the result of hormonal fluctuations of estrogen and progesterone. Nothing new there, right?
Declining estrogen levels can upset the natural pH balance (acidic versus alkaline) in vaginal tissue causing a disruption in the natural moisture levels. The leads not only to an obvious dryness, but secondary symptoms such urinary tract infections can also result from the irritation as well.
If the pH environment of the vagina (which tends toward acidic) leans too far to the alkaline side, unwanted bacteria, such as yeast, can multiply causing the dreaded yeast infections that so many women suffer with. In addition, low estrogen levels are also responsible for the thinning of the vaginal walls and a loss of elasticity, also known as vaginal atrophy. Both of which can give the sensation of vaginal dryness.
Things You Can Do
A lot of women resort to simple over-the-counter lubricants, but really, lubricants are, in my view anyway, just a temporary fix. Once the lubricant is gone, vaginal dryness is back. Though I think they have their place, certainly, promoting the natural moisture is the preferred route.
Probiotics, such as acidophilus milk and milk products, like yogurt, can help to put back necessary enzymes, which in turn helps to re-establish a healthy bacterial flora and therefore balance the pH environment of vaginal tissue. If you are not too fond of yogurt or other milk based products you can find probiotics in acidophilus tablet form instead.
Increasing phytoestrogens, which are plant based estrogens which are able to mimic our own body’s estrogens, can also help to increase vaginal moisture. Phytoestrogens can be found in soy products which contain soy isoflavones and other food sources such as flaxseed, flaxseed oils, legumes (beans), nuts, apples and cherries, just to name a few. Increasing phyoestrogens in your diet is one of the easiest and most effective ways to combat vaginal dryness.
Taking a medical grade nutritional supplement, such as a multivitamin, to boost your body’s ability to heal itself by can be helpful. The preferred method of course is always by way of good, wholesome food sources. But, if you find you need an extra kick, a good supplement can be helpful.
Vitamin A, beta carotene, and the B vitamins are particular helpful in treating vaginal dryness. And Omega-3, essential fatty acids not only help support health cell membranes in our body, but they also help promote hormonal balance as well. And believe it or not, increasing your water consumption can be extraordinarily helpful. A well hydrated body has a much better chance of restoring a natural balance than one that is not. Besides, it’s good for your skin too.
Because vaginal dryness in perimenopause is associated with fluctuating and low estrogen levels, the obvious answer to the problem is to increase estrogen. I personally use the Vivelle Dot Patch, a bioidentical estrogen. In fact, vaginal dryness was one of the primary reasons I decided to use it. It works extremely well.
If you are interested in estrogen therapy, I strongly recommend that you stay away from Premarin, a synthetic estrogen made from a pregnant mare’s urine, and Prempro, a synthetic combination of estrogen and progesterone. Both Premarin and Prempro have associated with serious side effects.
That is not to say that bioidentical hormones are risk free. They are not. All hormone therapy has risks. Bioidentical hormones are less risky. If you are interested in exploring bioidentical hormones, you can download a PDF document here which lists all FDA approved bioidentical estrogens and progesterone, so you can discuss them with your doctor.
Things To Avoid
You know, some things are just a no brainer, like avoiding harsh douches (which includes vinegar). And as much as we love our bubble baths, perfumed sanitary products, scented toilet tissues and soap, the perfumes can irritate vaginal tissue. The harsh douches, well, do I need to say it?
If you’re having serious issues with this, you might also want to consider washing your underwear in non-perfumed clothes detergent as well. And of course, avoid tight clothing which can cause chaffing and rubbing and just make matters worse.
These are just a few suggestions that can help with vaginal dryness. Thankfully ladies, we live in a time where we have lots of choices. So let’s not suffer in silence or take this lying down.