During and after menopause, many women experience uncomfortable vaginal dryness. Many find this vaginal discomfort is as distressing as the hot flashes they endure. A new study offers a perspective on alleviating vaginal atrophy that some women will perceive as comforting, while others will find it disconcerting (JAMA Internal Medicine, March 19, 2018).
How Well Do Treatments Alleviate Vaginal Discomfort?
The usual treatment is estrogen, often as a vaginal tablet. Nonprescription vaginal moisturizing gels are also recommended. In the study, three hundred women were randomly assigned to get an estrogen tablet plus a placebo gel, a placebo tablet plus Replens, the active OTC moisturizing gel, or a placebo tablet plus a placebo gel. The study lasted three months.
“neither prescribed vaginal estradiol tablet nor over-the-counter vaginal moisturizer provides additional benefit over placebo vaginal tablet and gel in reducing postmenopausal vulvovaginal symptoms.”
What Do You Think?
An editorial that was published alongside the study suggested that this is good news: it implies that any of the gels that are sold over the counter are about as good as Replens at relieving vaginal discomfort. After three months in the study, all the women reported improvement. And although some women may benefit from vaginal estrogen, the outcome of this study doesn’t suggest that it is necessary for women who may not want the additional estrogen exposure.
What Can You Do to Relieve Vaginal Discomfort?
We have gotten a number of questions from women struggling with vaginal dryness, as this young woman is:
Q. I’m 33 and had a partial hysterectomy at 27. I started a medication at 28 that affected my libido and caused vaginal dryness. This is very hard, especially at my age.
My doctor recently recommended using Crisco shortening before intercourse. This really shocked me! I’m so embarrassed to ask this, but what products will help with the dryness and not have a bad taste (if you catch my drift)?
A. Olive, almond or coconut oil might do the trick. Other options include aloe vera gel or a commercial product called Sylk that contains kiwi fruit vine extract.
Other readers offered their favorite solutions for this problem.
“I had a gritty-feeling vaginal itch about a year. (The never ending gifts of menopause). What finally worked for me was Queen Helene’s Cocoa Butter. I put it on after a shower (not over a raw area) and keep a small jar close by to re-apply as needed and haven’t had a bit of trouble with dryness again.”
PB has a different favorite:
“Cornhuskers hand lotion is the answer. Slick as KY Jelly, inexpensive & it is water soluble.”
Gail is happy with a vaginal estrogen product:
“I have had atrophic vaginitis for years. My doctor prescribes the Estring which is a rubber-like ring that you put inside your vagina and it stays there for 3 months. It releases estrogen gradually during that time. You have to get a new one every 3 months. Also, on days when my vagina feels particularly dry even with the Estring, I use a Vitamin E suppository that is equally good for mild hemorrhoid discomfort. Works for me!”
Other women have found that taking hyaluronic acid tablets as a supplement provides unexpected relief from vaginal discomfort and dryness. Others stick with topical applications, such as aloe vera gel.
Aloe Vera Gel for Vaginal Dryness:
Q. I have been using aloe vera gel for vaginal dryness on the recommendation of my urologist. It works for me and I wanted to share this with your readers.
A. You are not the first one to suggest aloe vera gel. Another reader sent this:
“My husband and I can’t use KY Jelly or any other lubricant we have tried. They make me itch and burn.
“We have found, though, that the slimy gel that oozes from aloe leaf when you break off a piece is a very good lubricant. I hope this will help another couple.”
Dermatologists caution that some people are sensitive to aloe vera gel, while other react badly to topical vitamin E. It makes sense to test any lubricant on the forearm before putting it someplace very sensitive.
You will find a number of other suggestions for easing vaginal dryness, including olive oil and coconut oil, on this site. Aloe vera gel should be more compatible with latex-based contraceptive protection such as condoms and diaphragms, when that is a consideration. Oils destroy latex.
Other solutions to assist with vaginal dryness include the prescription drug Osphena.