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This article is in response to a question from a reader. She is menopausal and asked what lubricant is best for intercourse.
Normally, the walls of the vagina are coated with a thin layer of clear fluid. With sexual arousal, this natural lubricant is increased and the woman becomes wet. This wetness is created by the body to assist in love-making. The hormone estrogen is key to this process, during menopause estrogen gradually declines, reducing the amount of moisture available. This decline also causes the vaginal lining to thin and become less elastic. All of this adds up to dry, painful intercourse.
What other things can cause vaginal dryness?
- Stress, from the challenges of couple relationships, family, work, running a household, maintaining a car and driving, that is, life.
- Health, another stress if dealing with cancer. Surgery, chemotherapy and radiation therapy can cause vaginal dryness. Conditions from diabetes, autoimmune diseases, to smoking can increase symptoms of vaginal dryness.
- Medications, especially antihistamines and decongestants used to treat colds and allergies, dry up not only nasal mucous, but also mucous in all parts of the body. Anti-estrogen medications used after the diagnosis of breast cancer, endometriosis, and fibroid tumors.
- Certain antidepressants
- Douching
- Lack of foreplay
What is the treatment?
In menopausal women, the first line of therapy is topical vaginal estrogen.
Vaginal estrogen cream is historically the most common treatment. This was followed by the development of estrogen tablets. The most current development has been the introduction of vaginal estrogen rings. They all work, so whatever works best for each individual patient, usually found by a trial of the medications.
What is available for the patient who is well estrogenized and still has the problem of vaginal dryness? Or for the patient who cannot use estrogen for medical contraindications? The answer is to use a sexual lubricant, of which there are three types.
- Oil-based lubricants like vasoline, baby oil, and mineral oils are in many home medicine cabinets. These can have a thick, greasy or oily feeling and can cause condom damage. That is important if condom use is for protection from getting a STD.
- Water-based lubricants, which are the most commonly used. These feel like natural lubrication and have no smell or taste, but they may dry out too quickly. These are usually recommended for sexual aids like vibrators.
- Silicone-based lubricants feel quite natural and last longer than water-based products. They don’t damage condoms.
The take-home message? Vaginal dryness and sexual discomfort can be easily treated. Talk over your estrogen status with your doctor. If dryness persists with adequate estrogen therapy, add a sexual lubricant. You and your partner will be pleasantly surprised with the results.
Resources
https://www.webmd.com/women/guide/vaginal-dryness-causes-moisturizing-treatments
