“Before, and sometimes during sex, I get very dry and it kind of spoils the fun. Is there something wrong with me physically? Or hormonally? I used to be able to become moist and now it's just gone,” says one of Health24's forum members.
"Worried" has a similar problem: “I'm a 49-year-old female, divorced, but have had a boyfriend for eight months. We have a wonderful sex life but my vagina is sometimes so dry that he can't penetrate me. Please help!"
Vaginal dryness is a hot topic on Health24's forums – as it is for millions of women worldwide.
In fact, up to 44% of women between the ages of 40 and 59 in menopause or post-menopausal stages experience vaginal dryness. Among these, 87% describe it as at least moderately bothersome, with 51% finding it "very" bothersome. After age 60, 70% of women experience vaginal dryness. This is according to a 2004 Gallup report on Vaginal Dryness.
Women age 45 and older on hormone replacement therapy (HRT) reported that, prior to the therapy, 30% experienced vaginal dryness. But after HRT, this number dropped to 26%. Among women on HRT who experience vaginal dryness, half reported they experience it daily.
"Vaginal dryness is a real problem that affects and interferes with women's daily lives. The effects of vaginal dryness range from minor discomfort to chronic pain," says Dr Machelle Seibel, a Professor of Obstetrics and Gynecology at the University of Massachusetts.
Why does it happen?
During menopause, the epithelial lining and the underlying tissues of the vaginal wall may become thinner and less elastic – a condition known as atrophy. This is due to decreased oestrogen.
Loss of vaginal lubrication may occur, resulting in soreness during and after sexual intercourse. Uncomfortable coitus may be one of the reasons why some women become less interested in sexual intercourse.
Vaginal dryness and thinning may continue after menopause. Some doctors estimate that at least half of all women over 60 have some degree of vaginal dryness. Vaginal changes may also increase the risk of infections due to reduced local protection against micro-organisms which may enter the vagina due to self-contamination or sexual intercourse.
Who suffers from it?
It is most commonly found in:
Women in perimenopause and menopause
Women who have just given birth or breastfeeding mothers
Women on low dose contraceptive pills
Women on chemotherapy for breast cancer
The following factors place women at greater risk:
Lack of regular sexual stimulation of the vagina
History of temporary amenorrhoea (missed periods)
Traditionally, oestrogen in the form of a cream or vaginal tablets has been used to help with this problem. However, many women cannot, or will not use oestrogen preparations as it increases the risk for breast cancer.
"The best bet for treating vaginal dryness is to use a vaginal moisturiser. Similar to the way a hand or facial moisturiser will deliver moisture and promote the healing of skin, an effective vaginal moisturiser will promote healing of the vaginal tissues and naturally restore vaginal moisture," says Prof Seibel.
It may also help to take a warm bath before intercourse. Regular sexual activity can also help to improve natural lubrication, and keep the vagina moist and toned.
Dr Lorraine Becker, a South African general practitioner specialising in sexual health, recently launched the At Last Comfort gel, a daily vaginal moisturiser which restores the normal vaginal bacteria and the pH level of the vagina. It also relieves the pain and discomfort associated with the condition and allows spontaneous intercourse without having to find a lubricant. The gel is safe to use by breastfeeding mothers and by women on HRT or undergoing chemotherapy.
When sex hurts
Female sexual problems