A decrease in blood estrogen levels is the cause of vaginal dryness. The "female" sex hormones, estrogens, affect hundreds of bodily processes, including the menstrual cycle. The tissue strength of the bladder, urethra, clitoris, vulva, and vagina is also preserved by these hormones. Women's estradiol estrogen levels decrease by 95% during premenopause and postmenopause.

When estrogen levels decline, usually due to menopause, women can experience the following symptoms:

• Less vaginal lubrication

• Thinning of vaginal tissue due to reduced collagen production

• Loss of vaginal elasticity

• Increased vaginal pH

• Loss of pubic hair

When combined, these symptoms represent a disorder known by medical professionals as vulvovaginal atrophy, atrophic vaginitis, vaginal atrophy, or, as of 2014, the genitourinary syndrome of menopause (GSM). Distress, pain, discomfort, and sexual dysfunction can result from GSM. Research indicates that up to 85% of women over 40 may be afflicted by this treatable illness.

A vaginal estrogen medication such as conjugated vaginal estrogen (Premarin) cream or estradiol (available in cream, pill, capsule, and ring form) may be prescribed by your clinician. Additionally, they might recommend vaginal inserts for prosterone (Intrarosa) or pills for ospemifene (Osphena). Increased vaginal secretions, a return to normal vaginal pH and microbiota, and strengthened vaginal tissue are all possible with vaginal estrogen therapy. Urinary tract advantages can also be obtained from these hormone medicines. Your doctor might suggest one of the following over-the-counter remedies for vaginal dryness if your symptoms are moderate:

• Nonhormonal vaginal moisturizers (bioadhesives) include Replens, Vagisil Moisturizer, Feminease, Moist Again, K-Y Liquibeads, Hyalo GYN, and Revaree suppositories

• Vaginal lubricants can be water-based (Astroglide, Slippery Stuff, K-Y Jelly), silicone-based (Pjur, ID Millennium), and oil-based (Elegance Women's Lubricant, Simply Slick)

In contrast to hormone-based menopausal treatments, over-the-counter vaginal lubricants and moisturizers can improve sex comfort and vaginal moisture, but they cannot stop vaginal shrinkage. Note that this information is meant merely as a general guide. In order to decide which (if any) vaginal atrophy therapies are medically necessary, your online physician or nurse practitioner will examine your medical history and symptoms.

Vaginal dryness is by no means the only aspect of vaginal atrophy, which many medical professionals now refer to as genitourinary syndrome of menopause (GSM). The following are just a few of the many symptoms that might accompany GSM:

• Vaginal burning, irritation, or itching

• Milky or yellow vaginal discharge

• Inflammation (swollen vulva or labia)

• Dryness during daily activities

• Dryness during sex

• Pain or discomfort during sex

• Sensitive vaginal tissue sometimes leading to small tears (fissures)

• Loss of vaginal elasticity (tightness)

• Recurring urinary tract infections (UTIs)

• Urinary urgency

• Pain or buring when urinating

• Levator spasm (sporadic pain in your rectum)

These symptoms frequently coexist with other typical menopausal symptoms like hot flashes.

Vaginal atrophy can have other causes besides menopause. The following are other potential causes of low estrogen levels:

• Childbirth (vaginal dryness postpartum)

• Breastfeeding

• Hypothalamus issues that lead to a period stopping (amenorrhea)

• Antiestrogenic medication

• Pelvic radiation

• Surgical removal of the ovaries

• Breast cancer

Although 51.4 years old is the usual age of menopause, younger women may also go through the transition. It's referred to as early menopause when it occurs in women between the ages of 40 and 50. This condition is known as primary ovarian insufficiency in women under 40.

There are no natural treatments for vaginal dryness that have been clinically shown to raise estrogen levels in the body. However, studies indicate that sexual activity can protect vaginal tissue, most likely by boosting blood flow to the region.

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