mature woman with doctor
Sexual Health

The Best Ways to Manage Vaginal Dryness

Most of us have experienced it – changes, dramatic or not, to our most private parts. Whether it’s vaginal dryness, painful intercourse, vaginal itching or burning, painful urination, even a drop in our pelvic floor, these conditions are upsetting and may affect your overall feeling of health.

According to Dr. Lauren Streicher, menopause expert, book author and assistant clinical professor at Northwestern University’s Feinberg School of Medicine, at some point every woman will experience vulvar and vaginal changes. In an interview, Streicher, who authored Sex Rx, said very few women between the ages of 45 and 90 find their genitals functioning the same way they did when they were younger. And that is natural. These changes, she said, are caused by a decrease in estrogen.

“Biologically speaking, women aren’t meant to have sex after their reproductive years,” Streicher says. “Women in this age group can [also] have medical problems that get in the way. Heart disease, diabetes, depression, all impact normal sexual function.”   Statistically speaking, she said a woman who’s had a heart attack or has been given a cancer diagnosis is likely to never have sex again.

On the other hand, a healthy 70-year-old woman is capable of having the same sex life as a much younger woman. But if that’s your goal, you’ll have to be proactive. “Don’t count on your specialist,” Streicher says. “Most doctors don’t ask about your sex life unless you ask them.”

Unfortunately, there are many women who aren’t asking. While 75 percent of menopausal or post-hysterectomy women report vaginal atrophy as negatively impacting their lives, only 63 percent recognize the condition as a chronic situation, and even fewer women ask their gynecologist or other medical practitioner for help with the problem.

So what is the solution? Unlike many physicians, Streicher is not a big pusher of hormone replacement therapy or even bio-identical hormones. “I have not prescribed Premarin in years,” she says, referring to the popular HRT drug that uses pregnant mare urine as its primary ingredient.

She acknowledges that a growing number of women object to how the drug is made and how the horses (and their offspring) are treated. “It is a political issue,” she says. “There are other products to use that are plant derived. There are drugs that are not hormones.” While Ospemifine, a daily pill taken orally, is now a popular choice, as is Estring, a soft, flexible vaginal ring clinically proven to relieve moderate to severe pain during sex as well as vaginal itch and dryness, Streicher is an enthusiastic proponent of a new FDA-approved CO2 laser treatment.