Vaginal dryness is a symptom that can show up at many different stages in a woman’s life, and it does not necessarily feel the same for everyone. With such variety in presentations, figuring out what will actually help is not always straightforward. Add in the overwhelming amount of information online, and it is easy to either feel completely lost in the options or just hope the symptoms will eventually go away on their own.
However, understanding your symptoms and getting to the root cause is an important first step in finding the right approach for your body. Pelvic floor physical therapy can be another valuable part of that process, helping you better understand what is contributing to your symptoms, helping you find what your body may need to feel more comfortable, and help you better understand treatment options for either over the counter or prescribed medication
Why does vaginal dryness happen, and what can it feel like?
Although there are external factors to vaginal dryness, such as uncomfortable or tight underwear, or even certain ingredients in laundry detergents or soaps, the major underlying factor is hormonal changes. And more specifically, estrogen level changes. A drop in estrogen has a direct impact on vaginal tissue, affecting their moisture, elasticity, and overall health. Changes in hormonal levels can happen at various points in a women’s life including changes in hormonal birth control, during pregnancy or breastfeeding, perimenopause or menopause, and certain medical treatments
And the presentation can vary among each woman as well. Some women report burning, irritation, itching, feeling of tightness or friction, or increased sensitivity. But sometimes the presentation goes beyond just simply dryness, and can impact other aspects of pelvic health including discomfort with tampons or pelvic exams, pain with sexual intercourse, or even urinary changes. Although dryness itself may seem like just a tissue problem, it can start a whole chain reaction. If penetration becomes painful, you may unconsciously start tightening your pelvic floor muscles in anticipation of that pain. Over time, those muscles can become overactive or have difficulty fully relaxing.
That is where pelvic floor physical therapy can be really helpful.
So…what can a pelvic floor PT actually do?
A pelvic floor PT can assess how your pelvic floor muscles are functioning, and not just how well they can squeeze, but how well they can relax, since both are important for healthy pelvic floor function. When vaginal dryness or pain with sex is present, it’s also common for the pelvic floor muscles to become tense or guarded, sometimes without you even realizing it. Your PT can assess this tension and work with you on learning how to relax and coordinate these muscles, while also looking at the surrounding muscles and structures that support the pelvis, including the hips and abdomen, to see if anything else may be contributing to your symptoms. And beyond the physical assessment, your pelvic floor PT can also help you better understand what you’re experiencing and how it may be affecting your pelvic health. This can be an important piece of figuring out what support or treatment may be appropriate for you.
Understanding your Treatment Options
There are several options for managing vaginal dryness, and understanding the difference between them can make it much easier to figure out what may be right for you. Lubricants can help reduce friction during sexual activity, while vaginal moisturizers are used more regularly for ongoing dryness. Non-hormonal options often contain hyaluronic acid, such as Revaree, while prescription treatments like localized vaginal estrogen or DHEA can address the tissue changes associated with declining estrogen. A pelvic floor PT can help you understand these options, answer questions about what you’re experiencing, and recognize when it may be helpful to bring hormonal treatment into the conversation with your doctor.
The goal isn’t to find one perfect product or treatment, it is to understand what your body is experiencing and address it from the correct angles. Sometimes that means a moisturizer or lubricant, sometimes it means talking with your healthcare provider about hormonal treatment, and sometimes pelvic floor PT is part of the picture too, particularly when pelvic floor tension or pain has developed alongside the dryness.
Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected]. We are in-network with several insurance plans and can help you confirm your benefits before your evaluation.