Vaginal dryness is a very common problem women face. In fact, as many as 13.9 million women age 18 and older have experienced vaginal dryness at some point in their lives.
Typically vaginal dryness is a sign that you're low in estrogen. But, there could be a number of reasons why you're experiencing vaginal dryness, such as hormonal changes, childbirth, and aging.
What are the symptoms of vaginal dryness?
Some symptoms of vaginal dryness include soreness, itching, burning, urinary frequency, and reoccurring urinary tract infections.
Talking to your doctor about vaginal dryness can make you feel incredibly uncomfortable. However, unless you do, you won't be able to manage your symptoms.
What are some natural ways you can relieve vaginal symptoms?
Jacob Teitelbaum, MD, joins Dr. Holly to discuss why you may be experiencing vaginal dryness and how you can help treat it.
RadioMD Presents:HER Radio | Original Air Date: March 25, 2015
Host: Holly Lucille, ND, RN
It's time to separate fact from fiction and health fads. It's time for the Dr. Holly Lucille Show. Here's Dr. Holly.
DR HOLLY: Hi there, folks. Thanks so much for coming back and joining me. You're going to be so pleased that you did because I've got the lovely Jacob Teitelbaum. Today we're going to be talking about...Oh, I see this so much in my practice and it's so tough because they bring it up at the last minute. It's vaginal dryness. There are some really great things, though, that we can do, as we're going through hormonal changes and if anything else is going on, to remedy this. Jacob, welcome.
DR JACOB: It's always great to be with you, Holly, and we're going to teach people today. Do you have dryness in the land down under? Do you have painful intercourse? Itching? Burning? Recurrent bladder infections? Have we got some answers for you today. So, Holly, should we launch into the most common causes of this?
DR HOLLY: Yes. I've got to tell you, Jacob, I see this all the time and it's that one of those things, at the 11th hour, "Hey, is there anything else? I want to make sure that I cover everything." And they'll say, "Well, yeah." So, I try to listen and get better and better with my intake forms, but people, as you say, "Is it too dry in the land down under," and I know you're going to help us think that 60 is the new 30.
DR JACOB: You've got it, girl. Absolutely. Because it's part of natural aging, which nowadays, is totally optional. So, I really think that 60 is the new 30 and probably going to move up to 70 being the new 30. It's just we really have choices these days.
DR HOLLY: Yes.
DR JACOB: So, first of all, if you have some problems, just know it can be taken care of.
DR HOLLY: Yes.
DR JACOB: Now, one approach to it and the most common cause would be peri-menopausal and menopause, but other things, such as cancer medications, radiation or chemo to the area. A lot of environmental chemicals. The Europeans just put out a report showing that the effect of environmental chemicals on hormones, simply on hormones, is costing of $100 billion a year in terms of medication and side effects. Things like that. It's ignored, ignored, ignored in the United States. If you've had your ovaries out or even sometimes if you have a tubal ligation, you're going to find that about 2 years after, or if you're putting creams that are irritable. So, any of these things can cause what is called "atrophic vaginitis".
DR HOLLY: Right.
DR JACOB: Where the vagina stops making enough of the adequate lubrication that you've been having all your life. Treatment is fairly simple, fairly straightforward. So, Holly, here's when I think it's he said/she said. My approach, I still think that using the natural bio-identical creams, the bi-estrogen combined with the progesterone, using proper dosing. I don't think we have to go to a super high dose, just .2 mg is fine for many women.
DR HOLLY: Yes.
DR JACOB: Others do better with two and a half, but I go with the lower in most cases. Most women will find that applying the estrogen and progesterone vaginally is the way to go. If you apply it to the skin after a year or two, your skin stops absorbing it, in many cases. It seems to stop working.
DR HOLLY: Right.
DR JACOB: If you take it orally, you get a host of other problems because it has to go through the liver first and that causes its own mischief. So, if you do it topically in the vaginal area, you're going to keep lush and full and you're going to have the lubrication you need. You're not going to be as prone to bladder infections and, basically, it's kind of like, I want to say "a lube and an oil job", but it's basically keeping all of our equipment young and healthy. To me, that's good thinking.
DR HOLLY: Absolutely. For the he said/she said, I'm going to have to absolutely agree with you on that one. The other thing I love about using it topically like "to the affected area" is that sometimes, you only need about once or twice per week.
DR JACOB: Yes. It's perfectly reasonable. Some people pulse it that way. My personal feeling, Holly, is that the body loves to be able to predict in what's coming and it loves routine, so I like to give things daily at a lower dose. Let the body know this is what's coming. You're going to have it. You're going to have the materials you need to work with. But, basically, whichever way works for people really works fine.
DR HOLLY: Yes.
DR JACOB: Let me give another nice, simple thing. Even if you're in your 20's for lubrication as a vaginal lubricant because many of the vaginal lubricants out there, they're like chemical stews you're putting in there. They may be good if you don't want to get pregnant. I wouldn't rely on them.
DR HOLLY: Right. They also, I think, like when we talk about, and this I got from you, sometimes when people go after those "energy drinks", it's a loan shark energy because sure, it's going to give it to you right up front, but it will take more back. I think those chemical lubricants might do the job in the exact moment, but over time, those chemicals actually create dryness.
DR JACOB: Yes. They create irritation. So, I'm going to recommend, living in Hawaii and the islands in the middle of the South Pacific, a tried and true approach which is coconut oil. Coconut oil is a brilliant vaginal lubricant and you can use it to make the popcorn, too, if you don't want to get all those other things you're talking about. But, coconut oil, it's pleasant. It's soothing. It's a wonderful lubricant. It smells good. Tastes good, for those that may have interest in that part of it. It's just wonderful. It works really, really well. It's a good, good, healthy way to do it. Get a liquid one. The one I use is Nature's Way. It's a liquid coconut oil. You don't want one that's solid at room temperature. It will work okay, too. It's just harder to use.
DR HOLLY: That liquid coconut oil from Nature's Way, the amount of medium chain triglycerides so, for folks that love their bulletproof coffee or that sort of caveman coconut, I would say, it's such a great product and to use it topically for so many different things. It has so many different effects and uses, but, certainly, vaginal atrophy is one of them.
DR JACOB: Yes. And then, if you have hot flashes with it, the black cohosh, can be very helpful. Holly, I'd like to launch into vaginal pain for a moment, too, because this is such a big problem. As you note, this is often a problem that, as you're walking out the door and you have a hand on the doorknob, the person goes, "Oh, by the way, also..." because people are afraid and they're embarrassed to talk about it. There's really nothing to be embarrassed about.
If you've got pain with intercourse, or even without, and it's called vulvodynia. You want to get it taken care of. There's no need for that. There's different kinds of causes. Most often, it tends to be muscular, from pelvic pain in the muscles where most physical therapist are near useless, in my humble opinion, for treating pain. First of all 10% know how to do trigger point work, and some of those specialize in pelvic pain release. They can be a god-send. They can actually go in and release the muscle. I'll tell you right now, your doctor will have no clue at all.
So, you've got to look up a physical therapist who specializes in pelvic pain doing myofascial release. If you have trouble sleeping and widespread pain, you could have fibromyalgia. We've talked about that on other shows. My book, From Fatigue to Fantastic, or The Fatigue and Fibromyalgia Solution will tell you how to get rid of the fibromyalgia. We've done a number of studies we've published on this. The medication Elavil in low doses, 10-25mg, or Lyrica. I usually use Elavil and one of the other two together at bedtime, which can be very, very helpful for vaginal pain syndromes, especially if there's a neuropathic component or a nerve component.
DR HOLLY: That's an old tricyclic anti-depressant right? The Amitriptyline and at low doses, it really can be very effective.
DR JACOB: And at high doses, has a whole lot of side effects. You don't need a high dose for pain—10-25mg.
DR HOLLY: Alright, Jacob. We've got 60 seconds.
DR JACOB: Well, basically, 60 is the new 30.
DR HOLLY: Yes.
DR JACOB: It's no longer necessary to go quietly into the dark night, as they say.
DR HOLLY: Yes.
DR JACOB: It's okay to die very young, but very late in life.
DR HOLLY: Yes. I love it. Jacob, any time I talk to you, I love that you keep reminding our listeners that these are optional issues. People are riddled with aches and pains and things that just don't feel good, but to empower them that these are optional issues; that there are natural, healthy things that you can do.
You can always know more about Jacob Teitelbaum at EndFatigue.com.
This is Dr. Holly Lucille. This is Mindful Medicine. You're on RadioMD and you can follow us on Twitter or Facebook @YourRadioMD. We'll be right back.