There are a couple reasons you might be feeling dry down there.
Most women know that they might need, um, some extra lubricant down there as they age. Due to decreased levels of the hormone estrogen, vaginal dryness after menopause is typical and expected, according to the National Institute on Aging.
But what if you’re younger—even decades from menopause? Is it normal to have vaginal dryness in your thirties or twenties, too?
Vaginal tissue stays lubricated thanks to adequate estrogen levels. Any drop in estrogen can lead to a drop in natural lubrication. As estrogen levels wane, vaginal tissue thins out, which can lead to inflammation and vaginal dryness.
For younger women, vaginal dryness is often related to taking birth control pills and other medications, according to Jennifer Wu, MD, an ob-gyn at Lenox Hill Hospital in New York City. “Patients are often surprised by this, and they don’t see it right at the start of the birth control use; they’ll see it perhaps after a year or two.”
Here are other possible causes of vaginal dryness in younger women, according to Dr. Wu:
Because of their effect on hormones, certain medications used to treat conditions such as breast cancer, fibroids, infertility, and endometriosis can often affect vaginal lubrication too.
Vaginal dryness can make sex painful, cause burning when you pee, and lead to soreness and itching. Not surprisingly, dryness is a common cause of low libido in women.
But here’s the thing: Vaginal dryness is treatable. “For patients that have vaginal dryness because of low estrogen—this may be patients who are menopausal or patients who are breastfeeding—we can actually replace the estrogen in the vagina [with] estrogen cream,” says Dr. Wu.
Vaginal estrogen creams moisten the vaginal lining (and might be more convenient than using lubricants right as you’re … well, trying to get busy.) When applied a couple times a week, estrogen cream can usually improve natural vaginal lubrication, according to Dr. Wu.
Is Your Hygiene Routine Causing Vaginal Dryness?
But a drop in estrogen isn’t the only reason you might be drying up. “If a patient is experiencing vaginal dryness due to some type of contact irritant, I have them eliminate it from their daily use,” says Dr. Wu. Irritants to avoid that can cause vaginal dryness include:
Scented soaps and bubble baths
These irritants “can kill the good bacteria in the vagina, and [then lead to] an overgrowth of the bad bacteria,” says Dr. Wu. “This can result in result in a discharge that’s very fishy; it’s something called bacterial vaginosis.” This infection is the most common vaginal infection among women ages 15 to 44, according to the Centers for Disease Control and Prevention. (Psst … making these underwear mistakes can also lead to a bacterial infection.)
But good news: The best treatment for vaginal dryness, according to Dr. Wu, is more sex. “You want the vagina to be used to having sex, and regular sex—one to two times a week—can keep the vagina flexible and lubricated,” says Dr. Wu.
00:00:00,000 --> 00:00:08,366
00:00:08,366 --> 00:00:11,618
Older patients often do complain
about vaginal dryness, but
00:00:11,618 --> 00:00:13,800
we also see it in younger patients.
00:00:13,800 --> 00:00:16,350
This is often secondary
to birth control use,
00:00:16,350 --> 00:00:18,600
especially low-dose birth control use.
00:00:18,600 --> 00:00:20,890
When you have a drop in estrogen levels,
00:00:20,890 --> 00:00:24,450
then the tissues in the vagina become
drier and thinner and less flexible.
00:00:24,450 --> 00:00:27,950
Patients are often surprised about this
and they don't see it right at the start
00:00:27,950 --> 00:00:30,540
of birth control use, they'll see
it perhaps after a year or two.
00:00:30,540 --> 00:00:34,590
Anything that alters your hormones such
as medications or breast feeding or
00:00:34,590 --> 00:00:38,380
pregnancy can then alter
the tissues of the vagina and
00:00:38,380 --> 00:00:42,720
make them drier, less flexible,
make it more painful for sex.
00:00:42,720 --> 00:00:46,610
For patients that have vaginal
dryness because of low estrogen,
00:00:46,610 --> 00:00:50,260
this may be patients who are menopausal or
patients who are breastfeeding,
00:00:50,260 --> 00:00:54,500
we can actually replace the estrogen in
the vagina by giving an estrogen cream.
00:00:54,500 --> 00:00:56,820
The estrogen cream is used
a couple times a week and
00:00:56,820 --> 00:00:59,930
patients will usually see
a response in the first week.
00:00:59,930 --> 00:01:03,460
If the patient is experiencing
vaginal dryness due to
00:01:03,460 --> 00:01:08,720
some sort of contact irritant, I have
them eliminate it from their daily use.
00:01:08,720 --> 00:01:11,350
I tell patients to avoid
perfumed soaps and
00:01:11,350 --> 00:01:15,100
bubble baths, avoid douches,
avoid any wipes.
00:01:15,100 --> 00:01:17,580
They can kill the good
bacteria in the vagina and
00:01:17,580 --> 00:01:19,980
they have an overgrowth
of the bad bacteria.
00:01:19,980 --> 00:01:21,970
This can result in a discharge
that's very fishy.
00:01:21,970 --> 00:01:24,500
It's something called bacteria vaginosis.
00:01:24,500 --> 00:01:29,380
My best prescription for vaginal dryness
and difficulties with sex is to have sex.
00:01:29,380 --> 00:01:32,653
You want the vagina to be used
to having sex and regular sex,
00:01:32,653 --> 00:01:36,534
one to two times a week, can keep
the vagina flexible and lubricated.
00:01:36,534 --> 00:01:41,545
Bacterial vaginosis - CDC fact sheet. Atlanta, GA: Centers for Disease Control and Prevention. (Accesse don April 11, 2018 at https://www.cdc.gov/std/BV/STDFact-Bacterial-Vaginosis.htm.)
Vaginal dryness. Washington, DC: U.S. National Library of Medicine. (Accessed on April 11, 2018 at https://medlineplus.gov/ency/article/000892.htm.)
Vaginal dryness alternative treatments. Washington, DC: U.S. National Library of Medicine. (Accessed on April 11, 2018 at https://medlineplus.gov/ency/article/002142.htm.)
What are the signs and symptoms of menopause? Bethesda, MD: National Institute on Aging. (Accessed on April 11, 2018 at https://www.nia.nih.gov/health/what-are-signs-and-symptoms-menopause.)