Dry vagina

Vaginal moisture is mainly produced by the cervix (neck of the womb) at the top of the vagina and eventually oozes out of the vagina – some vaginal discharge is normal. This means that there is a very slow flow of moisture through the vagina, and this keeps it clean, as it moves dead cells and the remains of the menstrual period to the outside. On average, a woman discharges 2 grams of dead cells and 3 grams of mucus through the vagina each day.

 

During sex. When you are sexually excited, two special glands at the entrance of the vagina, called Bartholin's glands, produce extra secretions. The moisture from these glands is more slimy than the moisture from the cervix, because its purpose is to provide good lubrication during intercourse. Its musky smell is the result of millions of years of evolution to increase female attractiveness to the male of the species, and signals that the woman is ready for sex.

Vaginal dryness can be a particular problem at and after the menopause, because of a lack of oestrogen (the female hormone). Oestrogen is responsible for the plumpness of the lining of the vagina, for the elasticity of the tissues round the vagina and for the production of the moisture from the cervix.

 

Oestrogen levels fall at the menopause, so the vagina loses some of its elasticity, its lining becomes thinner and it feels dryer. Because there is less moisture, there are fewer of the ‘friendly’ bacteria that help to keep the vagina acidic. When the vagina becomes less acidic, infections such as thrush can take hold, which cause further irritation and discomfort.

 

All these changes can make intercourse uncomfortable, so it is not surprising that about 40% of women report painful intercourse after the menopause. Another factor is that after the menopause, the Bartholin's glands are less efficient they take longer to produce the lubricating juices for sex, and produce less than in younger women. The American sex researchers Masters and Johnson showed that whereas younger women may become sufficiently aroused for penetrative sex in as short a time as a few seconds, menopausal women may take 5 minutes or more.

A dry vagina can be lubricated easily. For additional lubrication for intercourse, use a water-soluble lubricant (for example, KY jelly) or a vaginal moisturizer (for example, Yes, Sylk, Replens or Senselle) rather than a petroleum-based product like Vaseline, which may interfere with your natural secretions. Apart from Sylk (available by mail order and from some stockists) and Yes (available by mail order) (see Useful contacts), these products can all be bought from a pharmacy you do not need a prescription. Sylk is a lubricant derived from an extract of kiwi fruit; obviously you should not use it if you are allergic to kiwi fruit. It has a non-sticky texture very similar to natural vaginal lubrication. Some lubricants damage condoms; Sylk, KY jelly, water-based formulation of YES, Replens and Senselle do not.

 

Sylk, Yes and KY jelly are used just before intercourse. Smear the product liberally over the vulval area, particularly round the opening of the vagina.

 

Replens and Senselle are moisturizers that you use two or three times a week. They coat the inside of the vagina with a non-hormonal moisturizer, which lasts for a day or two, so they do not have to be used immediately before intercourse.

Leisurely sex with lots of foreplay. Taking time during sex is particularly important for the older woman. This allows the Bartholin's glands to produce the maximum amount of lubrication before penetration.

 

Simple lubricants, such as KY jelly, or moisturizers, such as Replens or Senselle, can be used if you need additional lubrication for intercourse.

 

Hormone replacement therapy (HRT) will increase vaginal lubrication and thicken the vaginal lining, but has risks. Therefore, HRT is not appropriate if vaginal dryness is your only problem; there are safer ways of dealing with dryness.

 

Vaginal oestrogen creams can be prescribed by your doctor if you prefer not to take HRT. For the first 2 or 3 weeks you use it every night, and it may be a few weeks (or even months) before you notice any improvement. After that, twice a week will be enough.

 

The creams can be messy. Some come with a special syringe (applicator) to help you insert the cream into the vagina. In fact, the applicators are more trouble than they are worth, because they have to be washed in warm soapy water after each use. More importantly, they tend to give you too much cream. Some of the oestrogen will then be absorbed through the vaginal wall into the bloodstream, where it could be harmful. It is better to smear the cream inside your vagina with your fingers, and not to be over-lavish. If you are not used to touching the inside of your vagina you may find this peculiar at first, but you will very soon become quite relaxed about doing so.

 

Unless you have had a hysterectomy, oestrogen in the bloodstream needs to be balanced by progesterone tablets, otherwise there is a slight risk of cancer of the uterus (womb). Hormone replacement tablets provide both oestrogen and progesterone, but vaginal cream contains only oestrogen. Some of the oestrogen from the cream will enter the bloodstream through the walls of the vagina. Therefore, to be on the safe side, some doctors prescribe progesterone tablets for women using oestrogen vaginal cream.

 

Because some oestrogen from a vaginal preparation (whether it is a cream, tablets or ring) may enter the bloodstream, there have been worries that it could cause health risks like HRT. So far, there is no evidence for this (Climacteric 2008; Dec 31:1–15), but research is ongoing.

 

Vaginal oestrogen tablets are another possibility. They need a doctor’s prescription. Each tablet comes in an applicator, which is about the size of a pencil. You insert the applicator into the vagina and press the end to release the tablet into the vagina. For the first 2 weeks you use one tablet a day, but later only two a week are needed.

 

Oestrogen-containing vaginal ring. This type of ring may be suggested by your doctor. The ring gradually releases oestrogen into the vagina. It has to be replaced every 3 months, and you must not use it for more than 2 years in total. It is not painful or uncomfortable, but you might feel a slight irritation at first. Some people find that it gets in the way during intercourse, in which case you can remove it beforehand and put it back afterwards. It is easy to take in and out – your doctor will show you how.

 

Black cohosh capsules can be bought from health food stores. Black cohosh comes from the root of a plant. It is commonly used for menopausal symptoms in Germany. A study in 1987 in Germany found that black cohosh had an oestrogen-like effect on the lining of the vagina, which might translate into better vaginal lubrication. However, this study has been criticized because, surprisingly, it also showed that oestrogen had little effect; scientists therefore think that the study may not be reliable. Black cohosh may cause liver damage; more research is needed.

 

 

Dr Phil Hammond discusses vaginal dryness, painful sex and urinary tract infections in his Expert guide to After the menopause

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Thursday, June 10th 2010

Useful contacts for Dry vagina

Click to see all the contacts that you may find useful in relation to vaginal vulva problems | Dry vagina

---

Add a comment

A problem shared is a problem halved: help others by sharing your frustrations or successes at tackling your health problem.

We have noticed that many of your queries are answered on the website, so please search for your problem before submitting a comment. As all comments are moderated, there will be a delay before your comment appears.

Display Name Age: 123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899 100+ Sex: Male Female Country: Select Country United States United Kingdom Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and The South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of Thailand Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Comment:

Submit

Discussion content reflects the view of individual participants only. Health Press Limited bear no responsibility for accuracy of participant comments and will bear no legal liability for discussion results. Comments will be moderated before posting and Health Press Limited reserves the right to delete any material. See About our site for our moderation policy

Comments on this article

Posted by Optional on 22/07/2010 at 03:25:23 pm

After 10 years of menopause am now suffering extreme vaginal/vulvar pain. hopeing Vagifem will help, but worried about side effects.

Posted by Optional on 21/07/2010 at 11:17:52 am

I got all what i needed and i will suggest to others this site,thank you very much it was a good explanation.

Posted by Optional on 18/07/2010 at 06:56:09 pm

Any info on new non-estrogen SERM drug for vulvo-vaginal dryness/strophy: OSPEMIFENE? Projected FDA approval 2010. I have severe vag.dryness & atrophy; affects all movement -can only walk 50-100 steps before moisturisers wears off. Then tissues swell, burn and are abraded. Thrush infection follows this tissue damage.Local estrogen tmts worked perfectly vor v/v pblms but caused raging thrush infections. Anti-fungal creams cause severe burning; Fluconazole now ineffective at high dose. Nizoral used now. This solves thrush but not dryness/mobility problems. Hyaluronic Acid (HA)used vaginally in Europe. Any news? 2 Itlaian companies: Products called: REPADINA PLUS(only HAcid; almond oil and anti-oxidants. no Parabens etc) Another with HA (Italy) SERENA

Posted by Jen on 14/07/2010 at 04:28:00 pm

My vagina used to be dripping wet all the time, but after I was with child my vagina has been very dry. I need KY intense lube just to have sex. Is there an atlernative?

Posted by Tee on 12/07/2010 at 01:07:06 am

Hi I'm just too much frustrated with my life right now! It's been two years I've been married still I was never able to have sex with my husband.I'm totally not getting what's wrong with me??What's my disease. When I was 18, I started to have itching in my vagina. It got severe in next three-four years.Then I visited a Doctor in my country (I'm recently migrated to Australia).She did all the tests and found no yeast infection or bacterial infection. I had swab test. Then she just gave some medicines of all kind of infections since the doc didn't find any infection & the itching & excessive discharge was unbearable for me. That stopped my itching. But I was loosing all kind of sexual sensation. When my boyfriend used to kiss me i used to get wet. later no matter how much I wanted to feel the kiss but it did nothing to me. after getting married every time we tried to have sex he could never put the penis inside. The Doc again checked, the vagina is wide enough , penis goes inside but the moment he pushes it inside burning starts on my vulva. It's so severe that I can't think of anything but to take it off. I don't even get enough lubrications from inside. I used K-Y jelly but it doesn't help that much & the burning makes me go nuts. I really don't know what to do anymore. My husband is really supportive. But now I almost kinda lost hope. How can I get rid of burning. Even my sensation on clitoris is lost. I don't even find it anymore. i could never have sex & I'm 26. Please HELP if anybody have any solutions!!!!!

Posted by Shelley on 24/06/2010 at 09:15:12 pm

I just read about the cervix producing moisture and I have to say that I can't believe that this is the first time I have heard of this. After almost 14 years post-op from a total hysterectomy,and suffering from some very annoying vaginal, bladder and kidney problems, that makes perfect sense to me. Logically I know that when you remove important body parts there has to be side effects but when most doctors tell you that you will have no problems and you don't really need these parts...well it is very discouraging and makes me quite angry. I feel like I have been working through menopause for 14 years and have many more years of this to deal with. All I can say is that I hope Women's health issues are taken much more seriously by the time my daughter has to deal with these issues. I am very proactive in searching for solutions to my health issues and always have been but it can be a very frustrating. I'll keep on educating myself and thanks for the interesting information. Good luck to all the other women out there struggling with these issues.

Posted by sunita on 19/06/2010 at 08:35:43 am

After pregnancy I doesn't feel wetness in my vagina plz suggest me how to solve this problem

Posted by nona on 17/06/2010 at 12:27:08 am

i want options of what i cn do to improve dryness during intercourse

Posted by Zoe on 05/06/2010 at 05:05:09 pm

My virgina eaches a lot so i want 2 know what should i use & 2 get it?

Posted by Optional on 26/05/2010 at 05:50:38 am

I have dry thinning itchy female parts. I need moisture and plumpness back. I have sex almost every day. what is best? ky only makes it slick for the moment. I dont have hot flashes etc. do you think sylk or yes will really work?

Posted by Optional on 05/05/2010 at 05:24:57 am

what is the causes of not having the feeling to have sex & dryness problem

Posted by Nancy on 19/03/2010 at 07:46:36 am

I menopause at the age of 45. I experience vaginal dryness during intercourse and I feel very uncomfortable. We use KY Jelly before sex. I started to use oestrogel recommended by pharmacy but every time when I apply on the skin, there is a burning sensation that last for few seconds. Is it safe to use? What is the best lubrication you can recommend. By the way, I never take HRT.

Posted by Optional on 18/03/2010 at 09:04:20 am

i WANT HAVE PREGNANCY BUT I AM UNDER MENOPAUSE STAGE , I WANT TO GET ON NATURAL , WHAT SHALL I DO AND HOW , IS IT POSSIBLE?

Posted by NIKKIl on 14/03/2010 at 04:54:10 pm

HAVE BEEN ON HRT 9YRS NOW HAD A FULL HYSTRECTMI. LAST 3 MONTHS VIGINA SMEEL AFTER BATHS

Posted by Optional on 10/03/2010 at 11:52:06 pm

good. informative.

Posted by Anonymous on 28/01/2010 at 08:16:00 pm

ploblems with dry vagina. please advise supplements or gels ect. not HRT

Posted by Anonymous on 25/01/2010 at 04:49:00 pm

m 25 n m experiencing the problem of vaginal dryness during intercourse and think this is disturbing to my partner as it appears as though m rejecting him.m dry even wen m excited.wat can i do n wat could be causing the problem?

Posted by blessing on 12/01/2010 at 09:20:00 pm

what is the causes of not having the feeling to have sex

Posted by sky on 03/01/2010 at 09:02:00 am

Hi I (female), 34 and married in year 2004 and tried to have intercourse. I have found that mu husband actually has problem of penetartion as my vargina very dry. after 6 years, i still cant get pregnant as penetration some only hakf way, how to get conceive. Please advise whether I can apply any cream into the vargina. Any food can help to improve the varigna dryness? Thank you. Regrad SKY

Posted by Susan Torry on 16/12/2009 at 11:31:00 pm

I had a hysterectomy 1977, and was put on HRT until 6 years ago. Hve suffered with a sore vagina, no discharge, and no particular itching, just very sore. Have been going back and forwards to GP. Sometimes they have given me canestan pessaries, and at first they worked, but then they said that my oestrogen levels were low, and they have now given me Vagifem for twice a week, and if I get sore in between then they have given me Elocon Cream to use. I am only getting relief for a few days at a time, and sometimes if I am lucky then a week. Is my GP prescribing me with the correct medication, or is there something that I can buy as well.

Posted by kristi on 13/12/2009 at 10:42:00 pm

I tried the Liquid Goddess and was happy with it, but it is strange to melt it first before use. very effective on the yeast issue though, have any of you tried the other one they make? not sure what the name is

Posted by Lebo on 10/12/2009 at 08:07:00 am

I started using the birth control injection (Depo Provesa) in May this year but didnt go for the second time because i had headacheas all the time and felt naucious because of it.My problem is that since getting the injection,i am expirencing vaginal dryness and my period is now iregular.It comes after 2months for two whole weeks.Is this normal?

Posted by Anonymous on 18/11/2009 at 02:07:00 pm

I've been using Starglide Bio Sensitive for a few months and love the stuff, it's all natural and has Aloe Vera which has really helped since going through the menapause. They've got a website www.starglide.co.uk

Posted by Anonymous on 18/10/2009 at 04:07:00 pm

had hysterectomy at 31. now have lost my sex drive,cant have hrt because of history of breast cancer and scares,any advice please.

Posted by Leah on 03/06/2009 at 12:05:00 am

I too have tried various lubricants which have not helped at all. I recently came across an interesting website which might be helpful to others as well. The website is www.vaginismus.com. After reading some of the information on this site I'm beginning to feel that this could be my problem. You also might be able to relate to their information.

Posted by ohlalal on 24/05/2009 at 10:08:00 am

im am having a vaginal problem, when my husband and i having a sex its really painful because of the dryness, im only 21, what should i do, so we can enjoy our sex activity?

Posted by Maria on 18/05/2009 at 10:38:00 pm

The directions on Replens says that a white looking discharge is normal as it is the old cells coming away from the vaginal wall. I have persevered but the white stuff is still coming even after a month. This is so embarrasing when being intimate I have decided to stop using it and give Yes a go instead.

Posted by CAROL on 27/04/2009 at 06:08:00 pm

After using Replens I now have a horrible thick green/yellow discharge which fortunately has no smell but I am having to use pads as it is so bad. Could anyone please advise? Thank you

Posted by Anonymous on 20/04/2009 at 09:47:00 pm

I have had breast cancer and am now experiencing vaginal dryness. I would like to use a vaginal lubricant with a dispenser to insert before having sex which is now painful for me. It must not give off hormones that would likely increase my chances of breast cancer returning.

Posted by Mommyof7 on 16/04/2009 at 08:39:00 pm

I use a product I found on amazon, called Liquid Goddess. it the best natural lube i have tried. no chems, lasts forever and it also fights candida. check their site out www.liquidgoddess.net

Posted by Anonymous on 05/04/2009 at 09:51:00 am

im having a problem of vaginal dryness during sex, my body does not respond to being romanced. im so scared of sex, it does real hurts and horrible but my boyfriend enjoys it a lot. i was sexually abused several times by men as a little girl, thats why im scared of sex. what i know is that it hurts! i really need help.