Our bodies change as we grow older, but we do not have to age without a fight. Vaginal dryness is a common condition affecting 50–70% of women after menopause. A lack of lubrication is the most common cause of dyspareunia (dis-puh-ROO-nee-uh) or painful intercourse.
A lack of vaginal moisture may have a significant impact on a woman’s sex life. Sex does not have to hurt. Fortunately, there are many available options to provide the vagina with moisture and make sex pleasurable.
Here are eight tips to help solve the problem of vaginal dryness.
1. Water-based sexual lubricants
Sexual lubricants reduce friction. Lubricants enhance the experience and eliminate painful chafing and burning.
The application of sexual lubricant as a part of foreplay is a simple trick for many women to improve sexual pleasure. Lube may be applied directly to the vagina, clitoris, or penis before penetration.
Not all lubricants are the same. Most lubricants available at a local pharmacy are water-based. Water-based lubricants are the safest choice to prevent sexually transmitted infections. They do not break down latex in condoms or sex toys. Water-based lubricants are ideal for those with sensitive skin or those prone to vaginal irritation.
Water-based lubricants do not leave stains on sheets and are easy to clean in the laundry.
Popular brands include Astroglide and KY.
On the downside, water-based lubricants dry out quickly. Rapid drying may require reapplication for longer sexual sessions. For those suffering from chronic vaginal dryness or inadequate natural lubrication during sex, they may be insufficient. Water-based lubricants are often suboptimal for postmenopausal women.
2. Silicone-based sexual lubricants
Silicone-based lubricants stay slippery longer, avoiding the frustration of rapid drying and reapplication messiness. This type of lubricant does not evaporate when exposed to air and provides a wet sensation for longer sexual sessions. Since they are not water-based, silicone lubes may be used in the shower or bathtub.
One popular brand is Platinum Wet. This Paraben and Glycerin free product reduces the risk of chemical irritation. Penchant Premium is another hypoallergic option ideal for those with sensitive skin.
Silicone-based lubricants may be more effective and pleasurable for monogamous couples at low risk for sexually transmitted infections.
Non-water-based lubricants have downsides too. They are messy. Soap and water must be used to remove them, and they will also stain sheets.
Silicone-based lubricants will break down latex condoms or latex in sex toys.
We can not underestimate the value of foreplay for those with chronic vaginal dryness. Foreplay gets the juices flowing by increasing sexual arousal. Blood flow to genitals increases, causing the vagina, labia, and clitoris to swell.
Better stimulation leads to more natural lubrication and an increase in vaginal elasticity. The vagina then secretes natural lubrication, which increases pleasure and reduces pain.
For those with chronic vaginal dryness, communicating sexual needs and desires to your partner is critical. Sexual partners may be unaware of the physiological changes and not know what to do. Providing feedback allows the partner to learn how best to meet your needs.
4. Vaginal Moisturizers
Multiple products over-the-counter products are available to help increase vaginal moisture. The basic idea is to prevent dryness and improve the vaginal ph balance. These products do not treat the underlying cause of vaginal dryness. They are useful for day to day use to alleviate discomfort and improve vaginal moisture.
Those will sensitive skin may benefit from avoiding products containing parabens, glycerin, or propylene glycol. These additives may cause skin irritation.
Popular products include Replens and Luvena.
5. Vaginal Estrogen
Estrogen is one of the most important female hormones. A decrease in the production of estrogen by the ovaries triggers physiological changes in the vagina. The vaginal tissues thin out, and lubrication decreases.
Breastfeeding, certain medications, and menopause all cause estrogen deficiency.
Prescription estrogen medication can be placed directly into the vagina to offset the deficiency. Low dose Estrogen applied directly to the vagina bulks up vaginal cells and increases blood flow. Restoring vaginal health allows cells to produce more moisture. Natural lubrication improves, and the more elastic vaginal walls reduce resistance to trauma during penetration.
Vaginal estrogen comes in a variety of forms from creams, rings, and vaginal tablets. All require a prescription and evaluation by a health provider before use.
6. DHEA supplements
The DHEA hormone is a highly effective alternative to estrogen therapy. Before menopause, DHEA levels are high. As the ovaries stop functioning, DHEA levels fall. DHEA supplements can be placed into the vagina to restore vaginal health, reduce intercourse pain, and improve vaginal dryness.
Only one medication is commercially available. Prasterone, sold under the brand name Intrarosa, is a plant-derived form of DHEA. Prasterone is inserted into the vagina once a day through an easy to use applicator. DHEA converts into estrogen targeting the underlying cause of dryness. It is FDA indicated for painful intercourse.
Prasterone requires a prescription and monitoring by a health provider.
7. Selective Estrogen Receptor Modulators
Another alternative to estrogen therapy is a class of drugs called SERMS (Selective Estrogen receptor modulators). These medications act directly on the hormone receptors. Direct targeting of the vaginal tissue increases the thickness of the superficial and parabasal vaginal cells.
Like estrogen and DHEA therapy, the restored health of the vaginal cells improves the natural ability to produce moisture and lubrication.
Ospemifene is the only FDA approved oral drug for vaginal dryness and painful intercourse.
Ospemifene requires a prescription and monitoring by a health provider.
8. Topical Sildenafil
Sildenafil is a popular medication used to treat erectile dysfunction in men by increasing blood flow to the penis. Some women benefit from the topical application of Sildenafil.
A pea-size amount of compounded Sildenafil cream is applied directly to the clitoris before intercourse. Sildenafil cream increases blood flow to the clitoris. For some women, the increased blood flow triggers more natural lubrication, improves pleasure, and helps to achieve orgasm.
Sildenafil requires a prescription and monitoring by a health provider for this off label use.
Vaginal dryness is a problem you don’t have to ignore
Vaginal dryness is a common symptom among women. Painful intercourse and vaginal discomfort are not problems to be tolerated. These options can help one restore vaginal health and enhance the sexual experience.