VAGINAL dryness is one of the most common symptoms for menopausal women and is oftentimes the reason for the low libido experienced by some as they age.

Declining oestrogen production in menopausal women usually results in the thinning and the drying out of the vagina walls. This means that less mucus is secreted to moisten the vagina and offer lubrication during sexual intercourse.

"As a result of the dryness of the vagina, sex becomes uncomfortable, maybe painful. The vagina bruises easily and there may be a little spotting during intercourse," explained obstetrician/gynaecologist Dr Douglas McDonald.

A drop in oestrogen levels also causes the vagina to become thinner and less elastic, and leads to other symptoms common in menopausal women such as hot flashes, irregular or no periods, mood swings and, in some cases, facial hair.

However, menopausal women are not the only persons who experience dry spells, and a drop in oestrogen levels is not the only reason for the lack of moisture in the vagina. Oestrogen levels also drop during radiography and chemotherapy treatment, in childbirth, or with the surgical removal of the ovaries or the use of anti-oestrogen medications.

"Suppose a woman has bilateral ovarian cysts and she has removed both ovaries, then she will be oestrogen-deficient," explained Dr McDonald.

Vaginal dryness is medically termed vaginal atrophy, and can be diagnosed by doing a pelvic examination, so that the other possible causes of the pain can be ruled out. Following diagnosis, the condition can be treated with some type of oestrogen therapy to restore some of the hormones to the body.

While some women get treated with topical oestrogen therapy, hormone replacement therapy (HRT) has proven to be the most effective because it gets the most hormones into your bloodstream. However, it could lead to other problems in women such as breast tenderness and vaginal bleeding.

"If you really want to restore the integrity of the vagina, it is best to use the topical hormonal cream rather than the hormonal intake," said Dr McDonald.

Vaginal oestrogen can be obtained in a tablet or cream form which can be inserted into the vagina to ease the vaginal discomfort. There is also the vaginal oestrogen ring which is a soft, flexible ring that is inserted into a woman by her doctor for about three months. The ring releases a steady stream of oestrogen directly to the vagina so that it remains lubricated.

Apart from oestrogen therapy and HRT, women can also use lubricants during sexual intercourse to make it less painful. Despite the pain of vaginal atrophy, most doctors advise women to continue having sex.