By: Shannon Pacella, DPT, PHRC Lexington
If you are anything like me, you most likely have a plethora of moisturizers at home (hand lotion, face lotion, body lotion, etc.), but what you probably do not have is a vaginal moisturizer. You might ask, “What is a vaginal moisturizer?” A vaginal moisturizer rehydrates dry mucosal tissue, is absorbed into the skin and adheres to the vaginal lining, mimicking natural vaginal secretions. Now you might be thinking, “Why do I need to use a moisturizer down there?” A vaginal moisturizer can help to alleviate the symptoms associated with vulvovaginal atrophy/atrophic vaginitis (thinning of vaginal tissues due to a reduction of estrogen).1
Commons symptoms of vulvovaginal atrophy include:
- Vaginal dryness/lack of vaginal lubrication
- Vaginal irritation/itching/burning
- Pain during intercourse
- Spotting after intercourse
- Pain/burning during urination
- Frequent UTIs and/or yeast infections
Vulvovaginal atrophy/atrophic vaginitis is caused by anything that lowers estrogen production, which includes:
- Oral birth control pills – learn more about OCP’s and loss of estrogen here
- Surgical removal of the ovaries
- Pelvic radiation
- Medications that may be prescribed to treat fibroids and/or endometriosis, such as: Lupron and Synarel
The loss of estrogen involved in vulvovaginal atrophy decreases blood flow to the vagina, causing vaginal tissue to become thinner, drier, and less elastic. The top layer of the cells lining the vaginal canal may be lost entirely, leaving the layer below vulnerable to inflammation, infection, or trauma when exposed to any pressure, such as during sexual activity, or with the insertion of a speculum.1 This loss of estrogen also leads to the vaginal environment becoming less acidic, reducing the number of beneficial flora/bacteria (lactobacilli) and encouraging the growth of organisms that cause vaginal and urinary tract infections.1
It is important to note that those with vulvovaginal atrophy/atrophic vaginitis may require the use of a topical estrogen cream in order to adequately manage the symptoms. A topical estrogen cream is something that requires a prescription from a gynecologist or primary care physician. Over the counter vaginal moisturizers are intended to be used as a non-hormonal alleviation of vulvovaginal atrophy symptoms, but may not be enough to combat the symptoms, and a hormonal option may be a better choice for you. Vaginal moisturizers are applied regularly (typically every two to three days).
Vaginal moisturizers provide relief by increasing the water content of the cells lining the vaginal canal and lowering vaginal pH, in order to maintain vaginal moisture and acidity. Vaginal moisturizers are particularly beneficial not only for women with symptoms of vulvovaginal atrophy that cause pain during sexual activity, but also for women who are not necessarily sexually active, but experience day-to-day discomfort. As vaginal moisturizers are intended to moisturize the mucosa, the majority contain water. In order for the water to adhere to the mucosa, they also contain either plant-based or synthetic polymers.2
Vaginal moisturizers are inserted into the vagina with an applicator, which can be messy (the vagina absorbs what it needs and sheds the rest), so it may be helpful to insert just prior to going to bed, and to wear a panty liner.
Here are some of the vaginal moisturizers on the market:
- YES VM:https://www.yesyesyes.org/products/yes-vm-natural-vaginal-moisturiser/
- Restore Moisturizing Vaginal Gel by Good Clean Love: https://goodcleanlove.com/products/bio-match-restore-moisturizing-vaginal-gel
- Replens: http://www.replens.com/Products/Replens-Long-Lasting-Moisturizer/
It is important to note that some women who regularly use vaginal moisturizers may still use a lubricant as needed before sex, for additional lubrication and comfort. For both moisturizers and lubricants, you may need to experiment with several products to find the one that’s best for you. To learn more about lubricants, check out this previous blog post here.
If you have symptoms of vulvovaginal atrophy or suspect you may benefit from a vaginal moisturizer, I would recommend consulting with your primary care physician or gynecologist first. You may also benefit from seeing a pelvic floor physical therapist here at the Pelvic Health and Rehabilitation Center if you are experiencing pain with intercourse, vaginal/vulvar pain, or pain with urination.
- Managing postmenopausal vaginal atrophy. Harvard Health Publishing. https://www.health.harvard.edu/womens-health/managing-postmenopausal-vaginal-atrophy
- D. Edwards and N. Panay. Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition? Climacteric. 2016 Mar 3; 19(2):151–161. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4819835/