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When Vaginal Dryness Affects Intimacy—Surviving Post Menopause

Medically Reviewed by

By the time a woman reaches middle age she experiences significant physical, mental, and emotional changes brought on by hormonal changes in menopause.  Once those occur however, many of them begin to dissipate as women progress through the perimenopause, (8-10 years leading up to menopause) and menopausal, (12 consecutive months without menstruation) phases of life.

Symptoms such as hot flashes, night sweats, loss of memory, irritability, and fatigue often become less frequent and less severe as time goes on.  Often, by the time a woman is postmenopausal, (the period of time between complete menopause, and the end of her life) only occasional bouts of these uncomfortable symptoms occur.  There are specific changes in a woman’s body however, that may actually worsen with the passage of time without therapeutic intervention and proper treatment.

Vaginal Dryness Due To Hormone Imbalance—The Toll on Intimacy

Vaginal dryness in post menopause, also known as, “atrophic vaginitis” is often not talked about and can negatively impact the entire female sexual response cycle if not effectively treated.  When vaginal atrophy occurs, roughly 50% of postmenopausal women will suffer symptoms such as vaginal itching, difficulty in vaginal lubrication, and painful intercourse, also known as dyspareunia.  Though none of these conditions are life threatening for women, they can be life altering.  What’s more, according to recent studies only about 20-25% of menopausal/post-menopausal women ever seek treatment from an OBGYN or other medical practitioner.  Many women simply suffer in silence, or choose to avoid intimacy altogether.

Other Post Menopause Symptoms

Vaginal atrophy affects other functioning, besides sexual activity.  It may also cause:

  • Vaginal walls to thin
  • The vaginal canal to become shorter and tighter
  • Urination pain/burning
  • Urinary tract infections
  • Incontinence/leaking of urine

Postmenopausal women have reported major emotional distress and a reduction in quality of life due to many of these changes.

While vaginal atrophy is often associated with the natural aging process and menopause, without proper treatment symptoms can progress, leading to a vicious cycle of sexual dysfunction. Because of difficulty with lubrication and painful intercourse some women may become sexually avoidant as well.

What Causes Vaginal Dryness?

Prior to menopause, the skin and tissues surrounding the vagina are thicker, moister, and more elastic because of fluids and mucus secreted from glands at the neck of the womb.  The female hormone, Oestrogen drives these secretions, and also stimulates cells to create Glycogen, a compound that helps the body produce, “good bacteria” to protect against infection.

After menopause, when the ovaries produce less Oestrogen, thinning of the vaginal tissue, as well as a reduction in glands that secrete mucous cause the loss of elasticity and dryness.  This loss of collagen, adipose tissue, (fatty tissue) and protective covering of glands results in skin irritation and changes in vaginal pH and normal lactobacilli flora.

Treatment Options After Menopause

Though roughly half of all post menopausal women experience uncomfortable symptoms involving vaginal dryness, many fail to discuss problems with their healthcare practitioner.  Embarrassment, cultural taboos, or self-blame discourage many women from ever seeking help. 

Many options exist for the treatment of atrophic vaginitis due to lower estrogen levels.  These include a number of lifestyle changes for overall general health, as well as, over-the-counter products and prescription medications. 

These include:

  • Reduction of perfumed soaps and laundry products
  • Diet of healthy fats containing Omega-3 acids
  • Low impact exercises including “kegel exercises”
  • Natural hormone replacement treatments
  • Hormone replacement therapy through patches, gels, sprays, creams and pills
  • Local estrogen treatment through Oestrogen creams, rings or pills
  • Topical lubricants

Many women experience a variety of uncomfortable symptoms leading up to menopause, and for many years thereafter.  Most of these can be managed with simple treatment and lifestyle changes. 

If you feel that symptoms are intensifying, or interfere with quality of life, it’s important to consult your gynecologist or healthcare practitioner.


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