Vaginal Dryness and Birth Control

Vaginal Dryness and Birth Control

 
For the last 50 years, birth control pills have given women the power to enjoy sexual activity without worrying about getting pregnant. But for some women, the very pill that allows this freedom can impact libido and vaginal lubrication such that they experience discomfort, itchiness or burning, pain during sex and for many, the desire to have sex in the first place.

 
Whether you’re using the oral contraceptives, a patch, or an injection, hormonal birth control basically mimics menopause. An imbalance or fluctuation in hormone levels can cause unwanted and uncomfortable dryness.

For Most Women, the Pill Is a Good Thing *

For the lucky majority of women, hormonal contraception enhances sexual health, erotic interest and sexual function. Some of the beneficial effects of oral contraceptives include the following:

• Effective contraception: The Pill gives women total control over their reproduction, virtually eliminating anxieties about unintended pregnancy. This can feel freeing and can boost sexual interest and energy.
• Relief from painful menstrual cramping: Monthly cramps can destroy interest in sex. By taming cramps, oral contraceptives can restore interest in sex.
• Relief from premenstrual syndrome (PMS): The irritability, bloating, breast tenderness, and other symptoms of PMS can reduce libido and impair sexual functioning. Oral contraceptives minimize PMS symptoms, making sex more possible and enjoyable.
• Less menstrual bleeding: Profuse bleeding can lead to iron-deficiency anemia, which saps energy, including sexual energy. Oral contraceptives reduce the volume of menstrual flow and can restore energy.
• Suppression of endometriosis: Endometriosis causes severe menstrual cramping, pelvic pain, pain during intercourse, and other symptoms that detract from lovemaking. Oral contraceptives are often relieve these symptoms.
• Reduced risk of uterine fibroids: These benign growths increase menstrual bleeding and can cause iron-deficiency anemia. Oral contraceptives make them less likely.
• Relief from severe acne: Some oral contraceptives are so effective at reversing this condition that several of them are approved for this indication.
• Increased libido: Because the Pill suppresses androgens, one would think that it would reduce libido. However, some Pill-takers report greater sexual interest.

For Some Women, the Pill Is a Problem *

A small but significant percentage of women on hormonal contraception experience symptoms normally seen only in menopausal women with low levels of estrogen, one of the hormones that increases sex drive and contributes to normal vaginal lubrication, thereby impairing sexual function. Some of these symptoms include the following:

• Loss of libido: Oral contraceptive-induced androgen suppression can diminish or destroy erotic feelings.
• Less vaginal lubrication: Since both estrogen and testosterone receptors in the vagina contribute to lubrication, it is understandable that low testosterone also makes things drier. Lubricants and vaginal moisturizers can help address this issues sometimes, but not always.
• Vulvar pain: Low estrogen and testosterone not only makes things drier, but also more painful, a condition known as hormonally mediated vestibulodynia. (The vestibule is the area at the opening of the vagina, and dynia is the Latin root for pain). The use of oral contraceptives for more than a year or two increases the risk of pain during and/or after intercourse.
• Thinning of the inner vaginal labia and vaginal entrance: Erosion of this tissue can make genital play uncomfortable.

Did you know?

Vaginal dryness can have an impact on sexual health and fertility. Cervical mucus is important for maintaining a balanced pH level in the vagina, protecting the vagina from foreign bacteria, and helping sperm to reach the uterus. Therefore, when the vagina is not lubricated enough it increases the chances of catching a sexually transmitted disease, and decreases the chances of conception. Thus, it is vital for women to seek treatment options for this condition, to avoid the potential health complications that could arise if left untreated.

Tips to Avoid and Treat These Clinical Problems :

Stay hydrated: Drinking six to eight glasses of water a day will help keep your tissues lubricated, including those below the belt.

Lubricants: Short-acting lubricants can be used to overcome the problem during sex. Many women turn to personal lubricants to help to reduce the pain that happens during sex. However, lubricants don’t provide a long-term solution, and vaginal dryness doesn’t magically disappear when you’re not having sex. The burning, swelling, and itching can bother you all day long. So, while lubricants may be adequate for the immediate sexual encounter, in all likelihood, you won’t feel like yourself until you find a solution that helps relieve your chronic dryness.

Moisturizers: Many women achieve instant relief simply by using a vaginal moisturizer. Moisturisers are designed for regular use to hydrate the vaginal tissues and can be used every day or two to three times a week. They have the advantage, over lubricants, of providing long-lasting hydration and relief of dryness and not just during sex.

Stopping Birth Control. Stopping oral contraceptives altogether will usually solve the lubrication problem, but may leave you vulnerable to pregnancy, so other contraception options can be explored.

Changing Birth Control: Changing oral contraceptives to a lower dose progestin formulation, with a shorter half life can be tried. These lower dose formulations still provide contraception but are less consistent in their suppression of ovarian function.

Estrogen supplements: If there is evidence to suggest a woman has low estrogen levels (very light, scant periods), additional estrogen can be given, in the general dosage range of post menopausal HRT (such as Premarin 0.625 or 0.3 mg daily, or topical vaginal estrogen). While adding additional estrogen can be effective, long-term use may pose added cardiovascular risks such as is seen in the medium-dose or high-dose oral contraceptives.

A final word…

No two women are the same, so the advice in this article is meant as a broad overview of the pros and cons of oral contraceptives and ways to mitigate some of the cons. For women concerned about unintended pregnancy or plagued by severe cramps, PMS, endometriosis, fibroids, severe acne, or profuse menstrual bleeding, oral contraceptive-induced relief may well pique libido and enhance lovemaking. But for women who develop vaginal dryness, vulvar pain, thinning of the vaginal lips, or general sexual malaise, oral contraceptives may deflate libido and impair sexual function.

Bottom line, every woman is different, and the final decision will come down to the individual woman, her medical situation, and how she reacts. The most important thing is to never suffer in silence. Do not be afraid to talk to your physician about this condition if you’re experiencing discomfort.