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Vaginal Dryness is a common condition, especially during and after menopause, caused by reduced Oestrogen levels, leading to discomfort, irritation, and painful intercourse. Treatment options include hormonal therapies, such as Oestrogen creams, tablets, or rings, and non-hormonal lubricants or moisturisers.
Vaginal Dryness is a common condition that can affect women at various stages of life, particularly during and after menopause. It occurs when the tissues of the vaginal lining lose moisture and elasticity due to decreased oestrogen levels. This can lead to discomfort, itching, irritation, and painful intercourse, impacting a woman’s quality of life. Vaginal dryness may also be associated with other factors such as breastfeeding, certain medications, or medical treatments like chemotherapy.
Treatment options include hormonal therapies, such as oestrogen creams, tablets, or rings, and non-hormonal lubricants or moisturisers, which can help restore comfort and vaginal health. It is important for women experiencing persistent vaginal dryness to seek medical advice, as this condition can often be effectively managed with the right approach.
Vaginal Dryness, or Atrophic Vaginitis, is a common condition characterised by irritation, discomfort, or itching both inside and around the vagina, as a result of reduced vaginal moisture and lubrication.
In most women, the skin and tissues around the vagina are kept supple and moist by fluids and mucus produced by glands located at the neck of the womb. This mucus helps to moisturise and lubricate the vagina. The female hormone, oestrogen, is responsible for maintaining the vaginal fluids and mucus at a healthy level, thus keeping the vagina healthy, elastic, and clean.
After the menopause, the ovaries produce less oestrogen, this fall in levels leads to thinning of the tissues around the vagina and a reduction in mucus production, resulting in vaginal dryness and its associated symptoms.
Other causes of vaginal dryness that are linked to an imbalance of oestrogen include breastfeeding, taking the combined contraceptive pill or antidepressants, removal of the ovaries or womb, and certain cancer treatments.
Vaginal dryness can also result from the use of perfumed soaps and products on or around the vagina, a lack of arousal during sexual activity, or an underlying condition such as diabetes or Sjögren’s syndrome. These factors can disrupt natural moisture levels and contribute to discomfort.
Vaginal dryness can affect women of all ages, though it tends to be more commonly experienced by older women who are going through menopausal changes. It is estimated that around 50% of postmenopausal women will experience symptoms of vaginal dryness.
Vaginal dryness may seem like a minor issue; however, the condition can have a significant impact on daily life as it can cause soreness, itching, painful sex, an increased risk of vaginal infections, and a more frequent need to urinate, all of which can affect a woman’s overall comfort and wellbeing.
If you are experiencing vaginal dryness as a result of an imbalance of hormones it is unlikely that your condition can be entirely prevented, however, there are certain lifestyle changes that you can adopt that may decrease the severity of your symptoms:
Non-Hormonal Treatments
Personal lubricating gels and moisturisers can effectively relieve discomfort and pain for women experiencing mild to moderate vaginal dryness. These products help hydrate and lubricate the vaginal area, and are particularly useful for women that are unable or choose not to use hormonal therapy.
Lubricants provide short-term relief and should be used to alleviate dryness before sexual activity. Vaginal moisturisers, on the other hand, work well to improve the moisture in the vagina, they need to be used regularly rather than just before sexual intercourse to maintain long-term hydration and comfort.
The efficacy of lubricants and moisturisers is generally lower than that of topical oestrogens, although some experts believe that when they are applied on a regular basis, these products can be nearly as effective as local oestrogen therapy.
Hormonal Treatments
Topical Oestrogen
One of the most effective ways to treat vaginal dryness caused by oestrogen imbalance is with an oestrogen-based topical treatment.
With topical therapy, treatment is applied directly to the affected area, restoring oestrogen to the vagina and surrounding tissues. This localised approach means that the level of oestrogen in the bloodstream doesn’t peak in the same manner as with tablets or patches, reducing the risk of side effects. Vaginal oestrogens can be very effective in patients with urinary symptoms and recurrent UTIs.
There are various topical preparations available, including vaginal tablets, rings, and creams, all of which are equally effective in treating vaginal dryness. These preparations should not be used as additional lubrication during sex; lubricating gels should be used instead.
A vaginal tablet or pessary is a very small medication that is inserted into the vagina using a compact applicator. It is used somewhere between every day and twice a week.
The vaginal ring is a soft, flexible device with a centre that contains oestrogen. Once inserted into the vagina, it releases a steady, low dose of oestrogen over a period of three months.
The cream is applied into the vagina with an applicator and is typically used somewhere between every day and three times a week. It is common to have more vaginal discharge with creams. Please note that oestrogen creams may damage latex condoms and diaphragms; if you are using these types of contraception, it is preferable to use vaginal tablets or the vaginal ring.
Most women will experience relief from symptoms within about three weeks of starting treatment. Optimal benefit usually occurs after 1-3 months but may take up to a year in some cases. If symptoms do not improve with hormonal treatment, then other potential underlying causes of the symptoms should be considered.
Oestrogen-based treatments may not be appropriate for everyone, particularly for those with certain types of cancer or those who are pregnant. In these cases, you may wish to consider vaginal moisturisers as an alternative.
Hormone Replacement Therapy (HRT)
Some menopausal women experience additional symptoms, such as hot flushes and night sweats, along with vaginal dryness. Vaginal oestrogen treatments will not improve these other symptoms but HRT tablets, gels, or patches can be effective treatment options.
HRT can help thicken and revascularise the vaginal walls, improving lubrication and alleviating dryness symptoms. HRT acts to restore the vaginal pH and is proven to improve urinary symptoms.
There are a number of advantages and disadvantages of using HRT and you should speak to your GP or a healthcare professional about the increased risk of serious health conditions before considering treatment.
Ospemifene & Prasterone
Ospemifene is a newer medication that is used to treat moderate to severe vaginal dryness in postmenopausal women who are unable to use local vaginal oestrogen therapy. Ospemifene is a selective oestrogen receptor modulator that has an oestrogen-like effect in the vagina, increasing the cellular maturation and mucification of the vaginal wall. Ospemifene has beneficial effects on bone and anti-oestrogenic effects on breast tissue. The most common side-effect is hot flushes.
Prasterone is biochemically and biologically identical to endogenous DHEA. It is approved for treating moderate to severe vaginal dryness in postmenopausal women. Prasterone is used vaginally once daily at bedtime, there are no restrictions on duration of use. Prasterone is associated with significant improvements in the severity of vaginal symptoms.
It is important to discuss any vaginal bleeding, unusual vaginal discharge, or urinary symptoms with your GP to investigate the cause.
You should also see your GP if your symptoms do not improve despite treatment as there may be an underlying cause.
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Our fully accredited and qualified UK prescriber then screens your completed medical questionnaire and assesses your suitability for treatment. If the prescriber has any additional questions or concerns, they will contact you directly for clarification.
Provided that the prescriber is satisfied that the treatment is appropriate, the repeat request will be approved, and a supply price provided. In the event that your request is refused, you will be informed of the reason and given referral advice.
Once your order has been approved by our prescriber, your treatment is then dispensed, packaged, and posted by our regulated pharmacy partner. Your order will arrive as quickly as the next day depending on your selected delivery option.
You can be confident that your treatment will be 100% genuine, safe, and effective as we only use medications procured from licensed manufacturers and trusted UK wholesalers.
Rest assured that your treatment will be delivered in plain packaging for complete discretion.
A straightforward medical questionnaire acts as a replacement to the conventional face-to-face appointment. This type of consultation process is quick and should only take around five minutes to complete.
The questionnaire consists of simple questions regarding your general health and the specific condition selected. Questions are easy to understand and similar to those that you would be asked during a GP appointment.
The online assessment is completely private and confidential and is conducted with the same professionalism and safety standards as you would expect from a regular appointment but without the need for an awkward or embarrassing face-to-face consultation.
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Our fully accredited and qualified UK prescriber then screens your completed medical questionnaire and assesses your suitability for treatment. If the prescriber has any additional questions or concerns, they will contact you directly for clarification.
Provided that the prescriber is satisfied that the treatment is appropriate, the order will be approved, and a free private prescription issued for dispensing. In the event that your order is refused, you will be informed of the reason and given referral advice.
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