Q: What are some causes of vaginal dryness?

A: Before menopause, the ovaries produce estrogen, which also helps to maintain a layer of clear fluid in the walls of the vagina necessary for lubrication. When we reach menopause and no longer produce estrogen, the amount of lubrication decreases.

There are also several causes of vaginal dryness not related to menopause, including: using certain allergy and antidepressant medications, using douches or scented soaps or lotions that can cause irritation, and the autoimmune disorder Sjogren's syndrome. Anxiety and other emotional issues can also play a prominent role.

Several lubricant treatments are available, including silicone-, oil-, and water-based lubricants. Try a water-based lubricant free of harsh ingredients such as alcohol, propylene glycol, and parabens.

Topical estrogen is frequently prescribed, as it is thought to be safer than systemic hormone replacement therapy. But even this low dose of estrogen may not be recommended for women who have breast cancer, a history of endometrial cancer, or undiagnosed vaginal bleeding.

The medication Osphena, a once-daily pill that acts like estrogen, has been touted as a potential treatment, but it may increase the risk of endometrial cancer and should not be used if you have abnormal genital bleeding, have had or are suspected to have a gynecological malignancy, have a past history of blood clots, strokes, or heart attack or if there is any chance you could become pregnant.

More natural treatments include coconut, olive, grapeseed, and sunflower oils. Vitamin E suppositories have also been shown to be beneficial.

Before starting any treatment, discuss your personal medical history with a health-care professional to weigh the risks and benefits.

Ilene Warner-Maron, Ph.D., is a licensed registered nurse and nursing home administrator who co-directs the MS program in aging and long-term care administration at the Philadelphia College of Osteopathic Medicine.


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