Common Symptoms of Vaginal Dryness:

The following are a number of real-life symptom scenarios:

The vagina got notably dryer with decrease in self-lubrication around sex activity while using birth control pills.

The vagina feels so dry you can’t engage in sex without use of lubricant, and even then, it still doesn’t have the same pleasurable sensation.

The condition of the vagina changed after having a complete hysterectomy. Hormone replacement therapy does not fully correct the problem.

Following menopause the vagina became dryer and sensitive. Intercourse became progressively more painful and causes bleeding. It feels like the vagina is being rubbed with sand paper.

After going off hormone replacement therapy the vagina became so uncomfortable that intercourse was no longer possible.

What causes Vaginal Dryness?
Vaginal dryness is almost always caused by vaginal mucosa estrogen deficiency with inadequate hydration playing a second role. A few medical conditions such as scleroderma, chemotherapy and /or radiation therapy damage can also cause vaginal dryness. FGI does not offer services for these ladder causes.

Answers to the vaginal symptom profile and general medical questionnaires that you have opportunity to provide in detail during registration will determine if estrogen deficiency with vaginal atrophy is the correct diagnosis to a high degree of probability. The Vaginal Fluid Analysis (VFA Test), if necessary, can confirm the diagnosis and the degree of the problem.

Role of Estrogen in Vaginal Health

The vaginal is very estrogen dependent organ. With sufficient estrogen stimulation, the vagina is thick, very elastic, non-sensitive and produces natural lubricant. When estrogen effect wanes, the vagina becomes more “atrophic.” As the effect advances, the vaginal mucosa lining turns pale pink, and finally whitish with sub mucosal hemorrhage spots. The vagina becomes more dry, less elastic, and sensitive to touch. Under these conditions the vagina also begins to shrink in length as well as diameter. Intercourse gradually becomes uncomfortable, if not painful and sometimes impossible.  While vaginal estrogen is the mainstay of treatment, most healthcare providers have their couple of favorites and if you don’t respond, well… then you’re out of luck. Furthermore, treatment is more difficult than what most physicians realize. First- there are five different types of estrogen for vaginal use, second- each woman can respond differently to each type and/or to the base it may be compounded in, third- some women require a higher dosage than others, and forth- three of the types are not available through the pharmaceutics industry but must be formulated at compounding pharmacies. Experience is the key to achieve good results!

Reasons for Lack of Estrogen

There are a number of reasons why the vagina can become under-estrogenized. Estrogen can wane in overall amounts with less ovarian production beginning in the mid-forties.   Lower systemic estrogen levels can occur due to increased life stress, excessive exercise, and being significantly under-weight. These are called hypothalamic factors because they down regulate the hormones secreted in the brain which regulate ovarian estrogen production. Some women on birth control pills can experience this problem. Although these women are getting flooded with high levels of estrogen, its synthetic estrogen known as ethinyl-estradiol which does not always effectively stimulate the natural or 17Beta estradiol receptors present in the vaginal mucosa. Changing pill types doesn’t help either because all the pills contain the same type of estrogen. Other women may have vaginal estrogen receptors that no longer function as well as they did in their youth. Smokers metabolize their estrogen faster. In many women, the effects of vaginal estrogen deprivation can occur after menopause or by stopping or reducing the dosage hormone replacement therapy. Whatever the reason, when the vagina lacks estrogen the mucosa starts to change; whether or not adverse symptoms occur depend on the genetics factors of the tissues and the lifestyle circumstances.

Expectations for Response

While FGI cannot guarantee full resolution or the degree of response to prescribed treatments which can vary from person to person, it takes 4 months before notable improvement may occur in the vaginal dryness. If not, the vaginal rejuvenate therapy may need to be changed because the vaginal mucosa of every woman does not uniformly respond to the same type or dosage of therapy. A vaginal fluid analysis (VFA Test) at that time can best clarify how to proceed. Fortunately, most women do experience relief of symptoms with the first line of therapy individualized to their situation.