Vaginal Dryness and Atrophy

What is vaginal dryness and atrophy?

Definition:

Vaginal dryness is when the natural moisture decreases within the vagina. Atrophy is when the vagina becomes less soft and flexible than it is normally during a woman’s childbearing years.

How do people describe vaginal dryness and atrophy?

Women describe vaginal dryness as an irritation that occurs while walking, sitting and during intercourse (sex). Vaginal infections can occur more often due to a lack of moisture.

Vaginal atrophy is described most often as pain in the vagina, such as during intercourse.

What happens to people when they experience vaginal dryness and atrophy?

Sitting, wearing pants, and intercourse can all range from uncomfortable to painful. Vaginal infections can happen more often.

What causes vaginal dryness and atrophy?

Vaginal dryness and/or atrophy can happen when the hormones women normally have during childbearing years decrease. This can happen because of menopause (change of life) or for a short time during chemotherapy.

Vaginal dryness and/or atrophy can also happen when radiation therapy is given in or near the vagina.

How do people cope with vaginal dryness and atrophy?

• Use long acting lubricants such as Replens or KY Jelly to help replace the natural moisture once a night for 7-14 days, then once every other night for 7 days, followed by once a week. This is helpful even if women are not having intercourse.
• Using lubrication during intercourse is a MUST; even if you think the long acting lubrication relives the dryness, the problem with vaginal atrophy is that the vagina is thinner and more prone to injury.
• Vaginal dilators can help re-expand the vagina to its normal size after surgery or atrophy until intercourse is comfortable.
• Do NOT use Vaseline, baby oil, or other oil-based lubricants because they can irritate the vagina.
• Lubricated condoms may be helpful along with vaginal lubrication.

What can family members and friends do to help me cope with vaginal dryness and atrophy?

• Your partner can help by listening to you describe how you feel as a result of vaginal dryness.
• Your women friends and family can help by giving you time to talk about the emotional changes brought about by changes in hormones and vaginal dryness.

How can I talk with my family members about vaginal dryness and atrophy?

• Many people find that talking about the vagina is difficult with anyone, even their doctors, but it is important to remember that your doctors and nurses need to know about dryness because of concern for vaginal infections.
• Some women find it easier to talk with other women about vaginal dryness and atrophy, while other women find it easier to talk with their spouse or partner.
• Be open and honest with your partner about vaginal dryness and how they can affect intercourse.
• Discuss that it will take longer to "prepare" for intercourse, but that you will be much more comfortable and responsive.

What should I report to my doctor or nurse?

• Vaginal bleeding or discharge that is unusual.
• Any signs of vaginal infection.
• Dryness or atrophy that does not respond to the use of long acting and immediate use lubricants.

Where can I get more information?

• American Cancer Society has a booklet on sexuality for women after cancer treatment, call 1-800-ACS-2345or on the Internet at: http://www.cancer.org/docroot/MBC/MBC_2x_OtherEffects.asp?sitearea=MBC
• Visit the Oncology Nursing Society’s information website at: http://cancersourcern.com, click on the reference center.
• Contact the National Cancer Institute at 1-800-4-CANCER or through the Internet at: http://www.cancer.gov/cancer_information/coping/

References:

1. Broekel, JA, Thors, CL, Jacobsen, PB, Small, M & Cox, CE (2002). Sexual functioning in long-term breast cancer survivors treated with adjuvant chemotherapy. Breast Cancer Research Treatment, 75(3): 241-8.
2. Shell, JA (2002). Evidence-based practice for symptom management in adults with cancer: sexual dysfunction. Oncology Nursing Forum, 29(1): 53-66.