Vaginal dryness: 'Women, please report symptoms,' urge experts

Vaginal dryness affects a lot of women, but most of them do not speak about this — not even to their doctors — and many won't take any steps to improve the discomfort. Why the secrecy?

Women can experience vaginal dryness (that is, a lack of vaginal lubrication) at any stage of life.

However, this problem is most commonly seen during or after menopause, when a woman's estrogen levels often plummet.

A dry vagina brings with it a number of other problems, such as irritation, itchiness, or a burning sensation in the genital area — particularly during intercourse.

Vaginal dryness can make sex painful and unpleasant and could even lead to postcoital bleeding.

With this being such an ordinary problem, especially for women at menopause, it would only make sense for it to be freely discussed, and for women not to have any qualms in looking for the best way of managing the symptoms.

But that is not what a new study, conducted by scientists from institutions across the United States — including the University of California, Davis, the University of Massachusetts in Worcester, and the University of Michigan in Ann Arbor — found.

The researchers analyzed data from the Study of Women's Health Across the Nation (SWAN) and revealed that most women do not report vaginal dryness to their physicians, and neither do they take any measures to ease this problem.

In a paper now published in the journal Menopause — of the North American Menopause Society (NAMS) — the research team explains that vaginal dryness is treated as a taboo topic. The first author of the study is Dr. Elaine Waetjen.

A common problem shrouded in silence

The SWAN tracked the data of 2,435 women over a period of 17 years (1996–2013), and, of all the study participants, 19.4 percent — who were aged 42–53 at baseline — reported experiencing vaginal dryness at the beginning of the study.

And, by the time that all study participants reached age 57–69, even more of them (34 percent) reported that they had vaginal dryness.

But the researchers note in their paper that despite the fact that these symptoms are felt by so many women, 50 percent of them fail to report them to their physicians.

Moreover, less than 4 percent of the women with vaginal dryness use any kind of therapy — such as estrogen tablets, vaginal creams, or vaginal rings — to address this problem.

The team also found that how much sex these women were having did not affect the degree of vaginal dryness or pain that they experienced during intercourse.

Some women, the authors explain, believe that having more sex could help to improve vaginal dryness, while others are put off of sex completely, hoping that abstinence will improve their symptoms. Yet neither approach has any actual effect on the physiological problem.

'Shocking' findings

The scientists were also able to confirm that hormone therapy was significantly more effective for women who experienced vaginal dryness following natural menopause than for those who had undergone menopause after a hysterectomy.

"Studies have confirmed that although more than half of women develop vaginal dryness as they become more postmenopausal, most do not report symptoms," explains the NAMS executive director Dr. JoAnn Pinkerton.

As recently as last year, another study — this one published in The Journal of Sexual Medicine — also found that most women do not receive therapy for vaginal dryness, and that many are not even aware that they can solicit medical advice about it.

"Some [women]," notes Dr. Pinkerton, "will try lubricants as they begin to develop pain with sex."

"However, if lubricants and vaginal moisturizers are not enough, there are highly effective vaginal therapies such as vaginal estrogen tablets, creams, the low-dose ring, and the new intravaginal dehydroandrosterone," she says.

"It's shocking that less than 4 percent of women in the SWAN study were using these effective therapies by the end of the study period. For women, please report symptoms, and for healthcare providers, please offer safe, effective therapies."