Vaginal Dryness

Introduction

• Description: Vaginal dryness is characterized by the loss of normal vaginal moisture resulting in irritation, itching, or pain with intercourse. This loss may result from alterations in vaginal physiology caused by an infection or the loss of estrogen stimulation (atrophic change). This may also occur situationally because of inadequate or inappropriate sexual stimulation, sexual phobia, or pain.

• Prevalence: Common in menopausal women not undergoing estrogen therapy. Estimated to affect one in five women around the time of menopause and in more than half of women after 5 years without normal estrogen levels.

• Predominant Age: Postmenopausal.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Loss of estrogen stimulation (menopause), vaginitis, vaginismus, arousal disorders.

• Risk Factors: Loss of ovarian function because of age, chemotherapy, radiation, or surgery, vaginal infection, arousal disorders.

Signs and Symptoms

• Sensation of vaginal dryness

• Vaginal itching or irritation

• Insertional dyspareunia

• Dry, inflamed vaginal tissues seen on pelvic examination

• Loss of normal vaginal rugae

Diagnostic Approach