By Andrea Martin, DNP, CRNP, WHNP, Women’s Health Nurse Practitioner, Virtua Sexual Wellness & Pelvic Health

You're standing in the feminine-product aisle at the store—eyes shifting nervously from the Kotex to the K-Y Jelly. You want to pick up the K-Y, but you don't want anyone, including the checkout guy, to know about "your" problem (whisper—it’s vaginal dryness).

The myth is that this problem is yours alone. What's marvelous is that there’s lots you can do about it.

MYTH: Other women aren’t having this problem.

If you’re dealing with vaginal dryness, the first thing you should know is that you’re not alone. The discomfort, sometimes accompanied by soreness, itching, or burning sensations (especially during or after intercourse), is, unfortunately, a common condition.

Nearly half of all women over 40 experience vaginal dryness, and that number grows when you add in younger women who have recently had a baby, are breastfeeding, or take certain kinds of birth control. Lower estrogen levels are generally to blame.

Estrogen keeps the vagina healthy by promoting blood flow and ensuring that its cells are plump and oxygenated. When estrogen decreases and blood flow isn’t as robust as it once was, cells shrink, the vagina becomes less stretchy, and dryness occurs.

MYTH: There's nothing I can do about it.

Good news—there’s actually quite a lot you can do to alleviate the discomfort of vaginal dryness. Potential treatments range from home remedies to prescription medications.

First things first: Are you drinking enough water? Your body needs water to produce its lubricating secretions—think tears, sweat, saliva, and, yes, vaginal fluid.

Next, you might take some time to familiarize yourself with the over-the-counter personal lubricants available. Many brands and product lines provide opportunities to experiment with different water-, silicone-, and oil-based formulas. Choosing what works best for you is a trial-and-error process. Some women may be sensitive to silicone-based products. Others may want to try coconut, mineral, or olive oil first.

Your provider can suggest prescription treatment if you experience persistent or acute dryness. Topical (vaginal) estrogen may be among the options available to you. The benefit of estrogen therapy is that it addresses the underlying problem and not just the symptoms.

Vaginal estrogen is an extremely safe medication that has few side effects. It comes in many forms—suppositories, creams, or rings that are inserted into the vagina—and very little is absorbed in your system.

If you’re experiencing vaginal dryness along with other menopause symptoms, you may want to explore systemic or “whole-body” estrogen therapy.

While menopause is a natural change in the body, the symptoms can greatly affect your quality of life—and you don’t need to endure them. Treatment often involves some combination of these hormones:

• Estrogen: This hormone workhorse prevents and treats most menopause symptoms. This can be taken as a pill, patch, spray, cream, or vaginal ring.
• Progesterone: Progesterone is a protective hormone and must be taken by any woman who has a uterus and is on systemic estrogen therapy. Estrogen alone can thicken the uterine lining, which shouldn’t happen during menopause. Progesterone prevents this, eliminating the risk of uterine cancer. Progesterone also promotes sleep and decreases anxiety. It can be taken as a pill or given as a progestin intrauterine device (IUD). 
• Testosterone: The hormone of desire and arousal, testosterone is used to increase libido, promote lean muscle mass, and improve mood, bone density, and cognition. It's administered as a topical cream.

In addition to treating bothersome symptoms of menopause like hot flashes, night sweats, mood changes, and brain fog, hormone replacement therapy has other health benefits as well, including reducing the risk of osteoporosis and hip fractures, reducing the risk of heart disease (the number one cause of death in American women) and decreasing the risk of developing colon cancer.

Hormone therapy isn't recommended for all women, especially if you have a history of certain cancers. However, women should still discuss other treatment options with their providers.

MYTH: Talking about it with my GYN will be embarrassing.

You’re not going to surprise your GYN provider if you bring up vaginal dryness. While raising the issue may be initially uncomfortable, it’s a conversation worth having. Your provider wants to help you deal with it so you don’t have to settle for discomfort or a disrupted sex life.

Find expert treatment for sexual dysfunction

• Virtua Sexual Wellness and Pelvic Health women’s health nurse practitioners provide specialized physical and emotional care for women experiencing pelvic discomfort or concerns related to sexual function. Call 856-247-7435 to make an appointment.
• Learn more about all your menopause treatment options.