Do you often feel dry “down there”? Vaginal dryness is a common condition for many women. In fact, if you are on the Pill, you’re 25 percent more likely to have vaginal dryness. Another major cause is perimenopause or menopause. Whether from age or the Pill, the vagina can degenerate as estrogen and/or testosterone (yes, women need testosterone too!) decrease, which leads to less lubrication.
Vaginal dryness can be one symptom of a prevalent but little-known condition called vaginal atrophy. Also called the genitourinary syndrome of menopause, vaginal atrophy occurs in up to 50 percent of perimenopausal or menopausal women. That’s over 24 million women in the U.S. alone. Add to that another couple of million women affected by the Pill. Vaginal atrophy is also associated with painful sex. (Note: While women experience the consequences of painful sex most directly, their partners are affected as well. Men might feel rejected, frustrated, guilty, and fearful about the situation. Be sure to communicate openly and honestly about this issue. This way, you can avoid disconnection and find alternate forms of intimacy while waiting for your symptoms to heal.)
What Can Be Done to Relieve Vaginal Dryness and Atrophy?
First Stop: Gynecologist
If you’re like many women, you may be embarrassed to approach a doctor (even a gynecologist) about vaginal dryness – or vaginal anything, for that matter. But this is the best place to start to rule out any serious medical issues. In fact, vaginal atrophy can worsen over time, so the sooner you speak to your gynecologist about treatment, the better.
Here are three tips to ease the situation when approaching your physician about vaginal dryness, pain during sexual intercourse, or other related symptoms.
- Bring someone you trust with you, be it your partner, a relative, or a friend.
- Tell the doctor that this topic is hard for you to discuss. She will usually provide focused attention when she knows it’s a difficult subject for you.
- Write or type your symptoms on paper, and give it to your doctor at the beginning of the appointment.
Gynecologists are very familiar with vaginal ailments and there to help you relieve your symptoms. So rest assured, they will not be embarrassed by whatever you ask.
Treating Vaginal Dryness
Once you’ve ruled out serious concerns, you can check out one of the many natural ways to lubricate your lady parts and remedy vaginal dryness or atrophy. Here are several options:
- Low-dose vaginal estrogen or other estrogen creams. This is usually the go-to remedy for vaginal dryness. According to research,  clinical effects can be excellent, with little to no side effects. Apply using your finger – not the applicator, which shoots the creams too high up for estrogen reception. Use 1 gram of the cream on the outside of the vagina, the inner vaginal lips, clitoris, and opening to the vagina. Apply another 1 gram to the lower third of the vagina.
- Estrogen tablets or plastic rings. A Cochrane Review showed that they are as effective as estrogen creams.
- Vaginal DHEA. In comparison with estrogens, the hormone DHEA seems to penetrate deeper into the vaginal wall, facilitating healing.
- Dietary phytoestrogens. Studies have shown that phytoestrogens – lower-dose estrogens found in foods or herbs – can improve vaginal dryness. Foods rich in phytoestrogens include flaxseed, flaxseed oil, soybeans, soymilk, tofu and miso.
- Hormone-free vaginal moisturizers or lubricants. For those concerned about using hormonal treatments, hormone-free options include vaginal moisturizers, such as Replens, or vaginal lubricants. Use these products liberally for the full effect. But be aware that they merely alleviate the symptoms short term. If you’re looking for an alternative substance to try, anecdotal evidence points to an herbal Ayurvedic balm called Shatavari Ghee for help with vaginal dryness. It is made from clarified butter and phytoestrogenic medicinal herbs such as Asparagus racemosus. Apply externally.
- I recommend four supplements for vaginal dryness:
- Vitamin E. This supplement has been shown to increase blood supply to the vaginal wall and improve menopausal symptoms. Doses of 50–400 IU per day are recommended. And don’t give up- it might be a month before you feel its effects.
- Maca. This dietary supplement has been shown to raise estradiol levels in menopausal women and help with vaginal dryness, as well as depression, memory, concentration, and energy. The recommended dose is 2,000 mg per day, and it comes in powder form. Sprinkle it into smoothies, yogurts, or puddings.
- Vitamin D. This supplement decreases the vaginal pH and dryness associated with vaginal atrophy.
- Probiotics. Researchers have found that the vaginal bacterial makeup varies according to a woman’s reproductive stage. Therefore, personalized probiotics could be helpful for tackling vaginal atrophy.
Many women feel relieved to learn that vaginal dryness is normal for their age or as a side effect from the Pill. Once you start treatment, you’ll hopefully find the relief you need.
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 Suckling, J., et al. “Local oestrogen for vaginal atrophy in postmenopausal women.” The Cochrane Database of Systematic Reviews 18, no. 4 (2006).
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 Parastou, Rad, et al. “The effect of vitamin D on vaginal atrophy in postmenopausal women.” Iranian Journal Of Nursing And Midwifery Research 20, no. 2 (2012):211−215.