Vaginal Dryness

Vaginal dryness occurs mostly due to a hormonal imbalance in the female reproductive system as well as in the tissues and membranes of the vagina.  This symptom is mostly associated with menopause.  Additional causes of vaginal dryness are childbirth,  breastfeeding, stress, birth control pills, medications, and other less common gynecological problems.

Symptoms include painful urination, sudden depression, itching or burning sensation or any other strange physical symptom, and pain or difficulty in having sex.

Why birth control pills causing vaginal dryness?

Among the side effects of taking contraceptive or birth control pills, the most common is vaginal dryness.  The vagina may lack the normal amount of natural lubrication. Although this is a normal side effect, itching or burning sensations, and difficulty having sex, can make life uncomfortable.

Pills actually have less estrogen than your own body would produce during an average periodic cycle. It does not allow your body to produce the normal level of hormones. Therefore, birth control pills may simulate menopausal effects by disturbing the natural hormonal level.

The contraceptive pill is made from progestin or a combination of progestin and estrogen. It affects vaginal moisture towards dryness by many ways.  First, most pills keep the estrogen level at almost the same low amount throughout the month in contrast the body’s natural ovulation cycle. A higher level of estrogen is important to maintain the normal mucus production in the vagina.  Second, while avoiding ovulation, the pill reduces the cyclical production of testosterone for libido. Decreased libido is the direct cause of the body’s decreased ability to respond sexual desire. Having less sexual desire leads to less lubrication in the vaginal area.  Third, pills having a low-dose of estrogen may not provide sufficient estrogen to maintain lubrication in the vaginal area. And finally, the estrogen in the pill causes an increase in a hormone (SHBG) that actually removes testosterone out in the circulation, leading to decreased libido and less vaginal lubrication.

What are solutions to minimize vaginal dryness using birth control pills?

During sex, use of a water soluble lubricant (any slippery aid like KY jelly or Astroglide) may help.

Change your dose of birth control as most pills are available with a 20, 30 or 35 microgram dose of estrogen (ethinyl estradiol), combining a dose of a progestin. Switch to a 35 mcg pill if using 20 mcg pills or use a high dose 50 mcg pill for a few months.

Oral estrogen for a few days a month for a short time after consultation may also be helpful as pills are having low-dose of estrogen may not be providing a sufficient amount of estrogen.

Drink more water and try to avoid dehydrating beverages like tea, coffee, and alcohol.

Use a multivitamin, exercise, and eat a balanced diet.

Does having a Tubal Ligation or a Tubal Reversal affect vaginal dryness?

Some women who have had a tubal ligation complain of a post tubal syndrome that includes vaginal dryness as well as other symptoms. Tubal reversal, specifically microsurgical tubal reanastomosis, can help these women who suffer from post tubal syndrome. The mechanism of why this occurs is not entirely clear, but for some patients tubal reversal is an option worth exploring.

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