Vaginal dryness— why no one is talking or doing anything about it?

A new study published in the North American Menopause Society's Journal Menopause identifies the factors associated with the taboo of not talking about vaginal dryness. According to the study results, more than 50% of women do not report vaginal dryness and less than 4% of those affected ever use any of the proven therapies.  

It is no secret that as the estradiol level plummets during the transition through menopause, most women experience vaginal dryness and dyspareunia. The Study of Women Across the Nation (SWAN) recruited a multiracial/ethnic cohort of 2,435 women at baseline and followed them over 17 years, with each woman clocking in approximately 13 visits.

This prospective cohort study identifies the incidence of vaginal dryness and its role in the causation of dyspareunia and frequency of sexual intercourse.

When the women were enrolled in the study, 19.4% of women (aged 42-53 years) reported vaginal dryness. At the completion of the study, 34% of women reported dryness (aged 57 to 69 years).

Advancing menopausal stage, anxiety, surgical menopause, and being married all contributed positively towards vaginal dryness.

Higher endogenous estradiol level was inversely associated with vaginal dryness in women not taking hormone replacement therapy. Whereas concurrent testosterone levels, concurrent dehydroepiandrosterone sulfate levels were not associated with developing vaginal dryness.

The study also highlighted the fact that the frequency of sexual intercourse was not related to the degree of vaginal dryness or pain during sexual intimacy. So, women who were thinking that having more or less frequency of sex is a remedy for vaginal dryness have to look for some other proven therapy.

Besides, HRT was more effective in managing vaginal dryness in women who transitioned into menopause naturally as opposed to those who had surgical menopause.

Dr. JoAnn Pinkerton, NAMS executive director, says in a press release, “Studies have confirmed that although more than half of women develop vaginal dryness as they become more postmenopausal, most do not report symptoms. Some will try lubricants as they begin to develop pain with sex. However, if lubricants and vaginal moisturizers are not enough, there are highly effective vaginal therapies such as vaginal estrogen tablets, creams, the low-dose ring, and the new intravaginal dehydroandrosterone. It is shocking that less than 4% of women in the SWAN study were using these effective therapies by the end of the study period.”

She urged women to please report symptoms, and healthcare providers to please offer safe, effective therapies.

Abstract

NAMS press release 

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