It sounds like an older woman’s problem, right? Well, yes- and no, no, no. It’s a touchy subject for many of us, an awkward issue that most women don’t even broach with our closest girlfriends. And it’s something we all confront at one time or another.
Vaginal dryness is taboo topic, likely because it weaves into our sense of our sexual selves and our desirability as women. We associate vaginal dryness with frigidity, imagining it means we’re lacking in sexual vitality and responsiveness. We find it embarrassing, and it produces anxiety that sincerely does stifle our arousal and ability to be present for a sexual experience.
So, let’s discuss the myriad of reasons why we might struggle with vaginal dryness, whether in a sexual encounter, or simply in maintaining comfortable, moist vaginal tissues as we go about our lives.
Vaginal dryness is often associated with menopause, but it’s actually very common in women of all ages. First, vaginal dryness can refer to different concerns. Sometimes, we’re talking about the condition of our tissues and daily moisture – even walking and sitting can be unpleasant when tissues are dry and irritated. But more often, when we talk about vaginal dryness, we’re referring specifically to sexual lubrication. In both cases, hormones are a factor, of course – and hormones are problematically shifty under many conditions and across the lifespan.
Lacking proper lubrication not only makes sexual intercourse uncomfortable, it can result in injury. Women experience pain and abrasions from sex when there isn’t sufficient lubrication, which can lead to an aftermath of irritation and inflammation. It even contributes to chronic yeast and bacterial infections, and increases the likelihood of transmission of STIs.
The conventional lubricant solution is a quick fix, with serious harmful ramifications to our health.
The majority of lubricants in the marketplace are damaging to women’s health. Not only do they contain toxic ingredients, they’re predominantly hyperosmotic, which causes inflammation of our tissues and disrupts cellular turnover, elasticity, and pH balance, resulting in dryness, burning, irritation, microbial imbalance and infection.
What are the reasons for vaginal dryness?
- Menopause/ Perimenopause
The most common and prevalent troubling experience of perimenopause and menopause isn’t hot flashes, irritability, insomnia or the overwhelming desire to run away from home- it’s vaginal dryness. All women will eventually move through this profound shift in hormones. It’s been said that it helps to think of hormones as our endogenous drugs, and that men and women aren’t different species – as often feels the case- but rather, we’re on different drugs. We’ve spent our adult lives learning to navigate our feelings and bodies with the familiar wax and wane of hormones, when suddenly everything changes. It affects the way we think, the way we feel, and the way our female bodies function. This change most notably impacts our fertility, sexuality and sexual identity. There’s much we can do to take care of ourselves. Let’s recognize that vaginal dryness is commonplace for women, including peri/menopausal women at mid-life, and research indicates that vaginal discomfort interferes with our sexual satisfaction and leads to loss of libido and intimacy avoidance. Intimate skincare is a ridiculously ignored need and obviously useful daily practice.
- Not Enough Foreplay/ Sexual Touching
The simple fact that we refer to the tantalizing talk and glimpses and fleeting touches, the move into kissing and erotic reverie as foreplay, is ever so regrettable. Sexual touching, moving into desire and the exquisite surrender that is a profound need for these creatures we are, longing to fully experience the bliss of the human condition… ah, it’s so very much more than penetration. But we suffer the illusion that it is only women who hunger for more, for a deeper well. The problem may simply be that men are culturally trained to be unaware of the altitude of possibilities that accompany a more sophisticated intimate encounter. Yes, it’s been studied; and yes, we’re far more aroused- and satisfied- when it’s more than a mechanical event.
- Natural Shifts During the Menstrual Cycle
Estrogen levels meaningfully impact vaginal lubrication. Estrogen levels rise and fall through the phases of our cycles, and we can experience vaginal dryness when estrogen levels dip immediately prior to, during and for a few days after our periods.
- Hormonal Imbalances
Women of all ages experience hormonal imbalances that result in vaginal dryness. Many people suffer from hormonal imbalances due to the endocrine system disruptors that are prevalent in our environment, from the foods we eat and body care we use to the clothes we wear and carpets we walk on.
- Pregnancy/ Postpartum/ Breastfeeding
The chaos of hormones during pregnancy tends to reduce the incidence of vaginal dryness, with the lift in estrogen- but the same said chaos occasionally leads to imbalances and vaginal dryness.
It’s common for women to experience vaginal dryness postpartum and during extended breastfeeding. Postpartum, the physiological, biochemical and psychological tumble results in a whopping 83% of women reporting sexual problems, including vaginal dryness and other similar miseries during the first three months after baby’s arrival. No intimate skincare is so heroic as to rescue us from the enormity of it all, but it can certainly give a boost. Breastfeeding is an important health-positive choice for both mother and child, but it’s accompanied by a few challenges. Prolactin, the hormone responsible for producing milk, also lowers estrogen levels and correspondingly increases the likelihood of vaginal dryness.
- Hormonal Birth Control Pills
For many women, hormonal birth control causes vaginal dryness. The pill, vaginal rings and patches, and hormonal IUDs are all culprits. These products manipulate a woman’s body, mimicking the second half of a menstrual cycle, which is a low-estrogen/ high progesterone state. Lowered estrogen is consistently a significant cause of vaginal dryness, regardless of the reason.
- Tampons and Toxic Feminine Hygiene Pads
Studies show a positive correlation between tampon use and vaginal dryness. We’re already experiencing low estrogen when we menstruate, and tampons further absorb vaginal moisture while also causing minor abrasions that can cause itching and burning. Even more troublesome are the toxins present in tampons and feminine hygiene pads, which commonly contain dioxins, furans, chemical whiteners, glyphosate, polyethylene (PET), polypropylene, rayon, fragrance, dyes and pesticide residues. These are linked to cancer, reproductive harm and endocrine system disruption. This is particularly offensive given that our vaginal and vulvar membranes are delicate and highly permeable.
- Feminine Hygiene Products
Conventional products lead to a nasty cascade of troubling conditions. Lotions, gels, sprays and ointments that contain broad-spectrum antimicrobials disrupt the critical balance of the vaginal ecosystem and lead to yeast infection and bacterial vaginosis. Many of the ingredients are synthetic toxins that are endocrine system disruptors and/or carcinogenic, and most of these products are hyperosmotic, causing a host of symptoms and creating health risks.
Many women are on antidepressants, and 83% of women taking SSRIs experience difficulties with arousal. Anticholinergic drugs, which are commonly used to treat overactive bladder or excessive sweating, are also known to cause vaginal dryness. Many pharmaceuticals have a general, negative impact on sexuality.
- Relationship Issues
Well, of course. Sometimes we have issues with a partner, and don’t find the space in our heads and hearts to become aroused. It can be a struggle with trust, anger, disappointment, emotional distance- when our bodies and feelings aren’t working in tandem, the arousal response can land with a thud regardless of prompts.
- Chronic Medical Conditions
Our reproductive systems become overtaxed and exhausted when we’re enduring the challenge of chronic illness. This can result in hormone dysregulation, and the physical and emotional stress of chronic illness is often accompanied by a diminished capacity to become aroused and self-lubricate. Some chronic conditions directly affect estrogen levels. Polycystic Ovary Syndrome (PCOS) is a condition that lowers estrogen and causes vaginal dryness, as do various disorders affecting the endocrine system.
Other reproductive system issues such as uterine fibroids and endometriosis cause pain during sex that results in anxiety, and that interferes with arousal and causes vaginal dryness. This is no distant concern: sexual dysfunction occurs in fully 43% of women with endometriosis. Both Diabetes Type 1 and 2 are also associated with an increased incidence of vaginal dryness. Notably, 73% of people with chronic pain suffer with sexual difficulties.
- Depression / Anxiety
Many patients managing depression with medication report experiencing sexual problems, and vaginal dryness is among reported symptoms. Furthermore, depression and anxiety lead to an accumulation of intersecting issues that interfere with the ability to become aroused and result in avoidance of intimacy.
- Stress. And Stress. And more Stress.
Stress not only affects hormone balance, when it comes to sexual arousal, stress can interfere profoundly. We all experience lowered libido at times, and studies show that stress has a decidedly negative impact on sexual appetite for most people. Under these circumstances, our bodies and thoughts can sometimes be gently coaxed into arousal with the addition of moisture… it wakes up the senses, reminds us that it’s possible.
Studies show an association between urinary incontinence and sexual dysfunction. Even minor incontinence can lead to vaginal dryness. Many women struggle with this issue, and developing irritated, itching tissues that don’t lubricate well is just one of the inconveniences we encounter with this condition. The ammonia in urine is drying, and alkalizes the tissues of the vulva and the vaginal entry. The resulting high pH can lead to yeast infections and bacterial vaginosis. Just sitting can be painful, and sex becomes out of the question.
- Strenuous Exercise & Low Body Fat
Athletic women sometimes experience issues with day-to-day vaginal dryness, as do some very slender women. Fat produces estrogen, and when we are very muscular with a low fat-to-muscle ratio, or if we simply don’t have much fat, it can result in a hormonal imbalance that causes dry, irritated vaginal and vulvar tissues.
- Cancer, Cancer Treatment & Cancer Survivors
Cancer is highly associated with sexual difficulties, including vaginal dryness and diminished libido. The stress, anxiety, depression, and use of pharmaceuticals contribute mightily, and the concurrent impact of cancer itself with the physiological intensity of cancer treatment is remarkably complex and stunning to the senses. These issues affect women in every stage of cancer, and after chemo/ radiotherapy when twice as many women suffer from vaginal dryness.
It may well be that some women with cancer are otherwise engaged and disinterested in sexuality, in which case the issue of vaginal dryness and intimate skincare is one of personal comfort and vaginal/ vulvar health. Other women will find themselves desiring the capacity for sexual intimacy and in need of both intimate skincare and sexual wellness information. Only 28% of women cancer survivors report that they were advised of the potential effects of cancer treatment options on their sexual function. Additionally, many women with advanced cancers report that medical providers assume that sexuality is of no interest to their patients and are not meeting their needs for sexual health support. According to one study, “sexual functioning/ sexual health are key aspects of quality of life for many cancer survivors, and are often not addressed by health care providers.”
- Cigarettes, Alcohol & Opiates
Cigarette smoking contributes to vaginal dryness both because it can lower estrogen levels and because it diminishes the population of desirable microflora, which results in vaginal dryness and a greatly increased likelihood of developing bacterial vaginosis. Alcohol and opiate use also contribute to vaginal dryness.
- Excessive Hair Removal
Not only is pubic hair removal uncomfortable at best - along with being time-consuming- it can lead to health issues, like vaginal dryness.
Hair removal is normalized now, but the fact is that it’s there for a reason. Anatomy tends to be like that – not a lot of unnecessary equipment. No one wants to hear this, but hair is hygienic. It draws sweat and funk away from our skin, and our bodies emphasize the use of hair where we most need it for cleanliness. Studies show that pubic hair removal diminishes general vaginal/sexual health by interfering with balanced vaginal ecology and pH – this biochemical climate results in dry and irritated tissues. Pubic hair removal is also substantially correlated with an increase in incidence of sexually transmitted infection.
- Not Enough Water
Proper hydration is an imperative for healthy skin, and our vaginas qualify for this truism just as well as our faces. Regular dehydration can lead to insufficient lubrication, itchiness, burning, and vaginal pain. Additionally, some chronic health conditions are associated with dehydration, as are many pharmaceutical drugs.
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