Oils, gels, lubricants, what to use?
Vaginal dryness is a very common consequence of the menopause and is due to the effect of estrogen deficiency on the vagina; blood supply, secretions and natural lubrication are all reduced. When this occurs along with thinning of the vaginal walls and loss of elasticity, the vagina can feel dry, itchy and generally uncomfortable, sometimes described as “broken glass” or like a “cheese grater”. Inevitably, this discomfort, reduced sensitivity and reduced response in the vagina, labia and clitoral areas, can have a significant effect on the pleasure of and desire for sexual activity, often leading to emotional distress and relationship problems. Further, vaginal dryness doesn’t just affect sexually active women, discomfort can occur just from sitting or wearing tight clothing.
To treat the underlying cause of estrogen deficiency, replacing estrogen can be extremely effective. This can be either in the form of Hormone Replacement Therapy (HRT) and would be used when other menopausal symptoms such as flushes, sweats, mood changes etc are also present, or, if the vaginal/genital symptoms are the main complaint, can be in the form of vaginal estrogen as a small vaginal tablet (Vagifem), pessary (Orthogynest), cream (Gynest or Ovestin) or a vaginal ring (Estring). These provide a very low dose of estrogen concentrated in the vaginal/genital area and are effective and safe, treating the cause—estrogen deficiency. Both HRT and vaginal estrogens need to be prescribed by a doctor or prescribing nurse.
Many women notice reduced lubrication during sexual activity early on in the menopausal process and wish to manage this, at least initially, with simple lubricants. Many types and brands of lubricants are now available and it can be difficult knowing which one to choose.
Some vaginal products may affect the effectiveness of condoms, whether used for contraception or for preventing sexually transmitted infections. Petroleum-based products (Vaseline, mineral oil and baby oil) may break down latex and can increase the risk of sexually transmitted diseases (or pregnancy) whereas water based products are unlikely to do so.
The most commonly used preparation is K-Y Jelly. K-Y Jelly was first patented in 1904 as a surgical lubricant, for short lasting lubrication during a vaginal examination, perhaps not ideal for a longer lasting effect required during sexual activity. More recently, preparations have been developed which are designed more specifically for reducing vaginal dryness and discomfort. These include Replens, Yes, Sylk, Astroglide, a range of Durex products and, the vaginal ovule, Repadina.
With many options to choose from, vaginal dryness can be treated and need not be simply endured.