Many women experience vaginal dryness. It has a variety of causes and can happen at any age, but is much more common during and after menopause.
Thankfully there are plenty of options to give relief from vaginal dryness.
The first step is finding out what's causing the discomfort.
What causes vaginal dryness?
Vaginal dryness, or to give it its medical name atrophic vaginitis, is much more prevalent in menopausal women and is a result in this instance of a lack of the female hormone oestrogen.
However, vaginal dryness can affect younger women too. It may be caused by a hormone imbalance, for example after surgery to remove ovaries. Breastfeeding mums can also experience symptoms.
Vaginal dryness may be a side effect from a certain medication or it may be the result of a health condition or treatment.
"Radiotherapy to the pelvic area, hormonal cancer treatments and sometimes chemotherapy can directly affect the vaginal skin and/or cause the ovaries to stop working leading to a drop in oestrogen levels," says Professor Janice Rymer, spokesperson for the Royal College of Obstetricians and Gynaecologists.
She adds: "Vaginal douches or substances placed in the vagina can cause dryness by disrupting the natural bacteria in the vagina."
Vaginal dryness may also have a psychological cause like anxiety or stress. Atrophic vaginitis could also be down to a lack of desire for, or arousal by, a partner.
"Vaginal dryness can occur after childbirth, or as a result of certain treatments for cancer and other health conditions, but is most common during and after the menopause, due to reduced oestrogen levels," says Wendy Green, author of 'Menopause: A self-help guide to feeling better'.
Menopausal vaginal dryness
One survey of post-menopausal women suggested that more than half of them will show signs of vaginal dryness after menopause.
Like many menopausal symptoms, vaginal dryness doesn't affect every woman. In addition, when symptoms do occur some women experience mild symptoms whilst others have more severe symptoms. Vaginal dryness can be an ongoing condition or it can just occur during sexual activity.
"It's down to a lack of oestrogen and often starts a few years into menopause," says consultant gynaecologist Dr Heather Currie, who is chair of the British Menopause Society.
She adds: "The loss of oestrogen leads to a change in blood supply and secretion making the skin of the vagina less elastic and supple. It also changes the acid balance making you more prone to infections."
Symptoms of vaginal dryness
1. Lack of lubrication. In general the vagina is naturally lubricated with fluids and mucus at the neck of the womb. The natural lubrications reduce during and after the menopause and the vagina becomes drier and more fragile. Sometimes even walking, playing sport, or wearing particular underwear can chafe and cause discomfort.