How to manage vaginal dryness effectively?

Question

Hello doctor,

I am 31 years old and have been dealing with vaginal dryness for approximately six months now. Sexual intercourse has become very painful, and I experience a burning sensation that lasts for several hours afterward. My libido has also decreased significantly, which is affecting my marriage.

My husband is understanding, but I can sense his frustration as well. I used to enjoy intimacy, but now I dread it because of the discomfort.

Could this be due to hormonal changes, or is it something more serious? What treatment options are available that could help alleviate the symptoms and potentially restore our relationship?

I am feeling desperate to address this before it causes permanent damage to our marriage.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Let me explain your issue. It is most likely a condition known as atrophic vaginitis, also referred to as vaginal atrophy. This is a condition in which the lining of the vagina becomes thinner, drier, and more fragile. These changes lead to symptoms such as itching, burning, and pain during sexual intercourse. Additionally, it can cause urinary tract symptoms, including urinary tract infections (UTIs) and urinary incontinence.

Causes:

Vaginal atrophy most often occurs during perimenopause and menopause, when the ovaries produce less estrogen. However, it may also occur when estrogen levels drop due to treatments such as chemotherapy or surgical removal of the ovaries. This hormonal decline can lead to a range of distressing symptoms that impact the quality of life.

Symptoms of vaginal atrophy (genitourinary syndrome of menopause): The tissue lining the vaginal wall becomes thin, dry, and inflamed. Common symptoms include:

Vaginal burning and/or itching.
Dyspareunia (pain during sexual intercourse).
Unusual vaginal discharge (often yellow).
Spotting or bleeding, especially during sex.
Vulvar itching (itching around the external genital area).

Urinary symptoms may include:

Frequent urinary tract infections (UTIs).
Urinary incontinence (involuntary leakage of urine).
Increased frequency of urination.
Painful urination (dysuria).
Hematuria (blood in urine).
Burning sensation during urination.

I suggest the following for management: One effective option includes the use of vaginal cream (conjugated estrogens).

Dosage: Apply intravaginally at bedtime for one month.

This topical estrogen therapy helps restore the vaginal lining, improve lubrication, and reduce symptoms such as burning and pain during intercourse.

With consistent use as directed, your symptoms are expected to improve significantly.

I hope this helps.

Thank you.