Best Fixes For A Dry Vagina in New York

The 3 Best Fixes For A Dry Vagina

Not all of you have come across this issue…YET. But for those who have, you are not alone. You may wish to be LEFT alone, but you are nonetheless in good company.  1 in 3 women between the ages of 40 to 65 experience vaginal dryness and painful intercourse.

Although there are many causes of vaginal dryness, hormonal changes are one of the biggest reasons.

Vaginal dryness can be super uncomfortable, may lead to increased urinary tract and vaginal infections, could cause unwanted odor and can interfere with maintaining intimacy in your relationships.  Why suffer?  Check out my three top fixes that are non-toxic and actually work.

FIX #1: If you wish to avoid hormones, try a Hyaluronic Acid Vaginal Moisturizer.

I recommend a compounded vaginal moisturizer that contains hyaluronic acid, aloe and vitamin E. Hyaluronic acid is naturally present in the vaginal lining (and other body tissues) and helps to maintain hydration. These compounded formulations are made to stick to the vaginal mucosa to provide increased hydration and protection from irritation. There is an over the counter version called Hyalo-Gyn, however, it contains propylene glycol (anti-freeze) which for obvious reasons, is not so appealing.  The obvious reason being it’s ANTI-FREEZE.

Other vaginal moisturizers like Replens and Luvena can be helpful, but they list some pretty not okay ingredients.  Your vaginal mucosa can absorb all sorts of chemicals, just like your skin and other mucus membranes.  The golden rule is: don’t put anything on your skin or in your vagina that you wouldn’t put in your mouth.  I’m talking ingredients people.  I’ll leave it at that.

The PROS: If you have reasons to avoid exposure to estrogen, this is a nice option.  If used correctly and consistently, it can be quite effective.  It is not meant to be a lubricant, but with consistent use it will reduce tissue friction and improve comfort.

The CONS: It may be inconvenient: it must be inserted 2-3 times/week and can be a bit cumbersome and messy.  It doesn’t necessarily improve the tissue elasticity or blood flow and so may not always improve pain with sex. Compounded formulas require a prescription.  Other OTC formulations are chock full of nasty chemicals which as we discussed should be avoided.

FIX #2:  Go directly to the source: Vaginal Estrogen.

The majority of vaginal dryness is due to low estrogen levels that begin to occur after age 40 and certainly after menopause.   Replacing vaginal estrogen topically actually restores what the tissue is missing.  In the beginning you will need to ramp up the treatment with daily use for the first two weeks to improve the tissue quality, natural lubrication and elasticity. It takes six weeks to start reversing the changes associated with loss of estrogen, so wait six weeks before “trying it out” with your partner or yourself. You will need a prescription so ask your doctor about the different vaginal estrogen options:

  • There is a ring that stays in the vagina for 3 months.  Kind of like an unwanted guest who happens to be a great chef, so you keep them around for 3 months. The ring is convenient because you don’t have to remember to do anything since it sits in your vagina for 3 months, but it may annoy your partner who may unexpectedly ram into what may feel to them like a hockey puck.
  • There are creams, which are handy because you can apply some of the cream on the outer labia as well since that part can also get a little dry.  They work well if used consistently but they may drip out in the morning.  They also should not be used before having sex since you will slather your partner in estrogen.  Don’t blame me if they start retaining water!
  • And finally there are tablets that are small, come with an easy to use applicator and aren’t as messy as creams.  The downside is the dose is lower than may be effective for 30% of women so that’s annoying, but you could increase the number of days a week you use it to overcome that issue.

The PROS:

  • It IS directly replacing the hormone that causes the dryness to begin with and is therefore quite effective when used consistently.
  • It is very low dose and doesn’t significantly impact hormone levels in the blood so it isn’t the same as taking HRT.

The CONS:

  • It may be inconvenient: some women find it annoying to have to use something in the vagina several times/week.
  • It can be a bit messy.  The creams drip out and the ring can lead to excessive vaginal discharge.  The pill can fall out randomly during the day.
  • If you have breast cancer or a strong family history of breast cancer or just generally wish to avoid additional estrogen exposure then you may wish to avoid using vaginal estrogen at all.  Most oncologists are okay with most women with a breast cancer history using vaginal estrogen therapy at least for short bursts of time and depending on the specific diagnosis.  Keep in mind there IS some absorption into the bloodstream so this may not be right for you.

Fix #3 The Best for Last Therapy

Vaginal CO2 laser or Vaginal radio-frequency treatment.  To me this is hands down the best option.  Why?

  • You get three relatively quick, non-invasive treatments in your doctor’s office and in 12 weeks, your vaginal tissue is restored to original factory settings.
  • This is the new kid on the block and patients love it. Several companies have developed vaginal rejuvenation therapies to address vaginal dryness, painful sex, vaginal laxity and even urinary incontinence. CO2 lasers traditionally used for facial rejuvenation and wrinkle reduction are now used to stimulate collagen and elastin formation in the vaginal tissue without any estrogen or the need for continuous treatment.
  • The treatments can also tighten the vaginal walls, restore tissue elasticity, natural lubrication and improve blood flow to strengthen the supporting ligaments around the bladder and urethra. Examples include the Femilift and Votiva Forma-V.
  • Each treatment lasts between 5-10 minutes (Femilift) to 20 minutes each (Votiva Forma V.) You will need one touch-up session after a year to maintain the benefit. This is a great option for those patients who don’t want to use estrogen hormone therapy, are not interested in having to continuously treat the vaginal tissue a few times a week or have not improved on standard therapy.

The PROS:

  • It is highly effective for vaginal dryness
  • It improves other vaginal issues if you have them (like vaginal laxity, reduced sensation, and urinary incontinence)
  • It does not require that you constantly have to put medications in your vagina every couple of days
  • It avoids chronic exposure to estrogen and chemicals

The CONS:

  • It’s pricey.  The initial therapy can range from $2500 to $3500 depending on where you live and which machine is used.  Annual maintenance costs range from $800 to $1000 a year.
  • There is a potential risk of burns, scars and injury related to the use of the laser, however, I believe this is related to non-gynecologists performing treatments and not selecting appropriate patients or not recognizing the presence of other vaginal conditions that could increase the risk for injury.   I myself have performed hundreds of these procedures with no injuries.   Also note that the Votiva-Forma V is a radio-frequency device that has much lower risk of injury compared to CO2 lasers.
  • It requires a single session yearly maintenance to continue to see the benefit in the tissue.  Without repeat treatments once a year the collagen and elastin will decline making the vaginal tissue thin again.

This is not meant to be an exhaustive discussion.  For that you can check out my article entitled “Why is My Vagina Dry and What Can I Do About it?”

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For more information about my wellness programs and my practice, check out my website drsadaty.com. Hey Look! You are already here…

Ready for the legal disclaimer? Information offered here is for educational purposes only and does not constitute medical advice. As with any health recommendations, please contact your doctor to be sure any changes you wish to consider are safe for you!