Health matters: Why am I so dry down there all of a sudden?

Dear ladies, if you frequently moisturise your faces, what stops you from doing the same for your lady bits? That is the question that haunted me when I interacted with Rispa at the Sexology Clinic. On her first visit, Rispa joked that her vagina was dead and that she was coming to the clinic to find out how to bury it without causing chaos in a marital relationship.

“I am serious, the thing (her vagina) is causing me agony, not pleasure and I want to pack it nicely and dispose of it,” she lamented.

Rispa problem was that she was having frequent vaginal discharges which the doctors described as vaginitis, an infection of the walls of the vagina. Further, sex was painful and whenever she attempted it she ended up with a burning sensation, visible cuts, and fresh blood stains.

“Sounds like you are suffering from vaginal dryness,” I suggested. 

Most women suffer a certain extent of vaginal dryness after delivery and during breastfeeding. Some hormonal contraceptives can also cause dryness. Then there are treatments such as radiotherapy, commonly done for cancers around the pelvis. A major cause is of course menopause. Many women get dry as they approach and during menopause due to hormonal changes in their bodies.

Menopause was not Rispa’s problem as she was in her 30s. 

“Well, I am only 35 so menopause is out of the question,” Rispa shared. A teacher herself, she was married to a 38-year-old lawyer. The couple had two children, and the younger was five months old. She was on a hormonal contraceptive.

“And how is your foreplay?” I asked to which she looked down while avoiding eye contact. Maybe she was shy, I thought. Foreplay is important in awakening the sexual system, causing arousal and increasing lubrication.

“Our foreplay is less than five minutes,” she said, “and it has been one of the sources of disagreement with my husband,” she blurted out.

She explained that her marriage had faced a difficult time after her last born. Baby care was itself draining and she was exhausted and paid little attention to sex.

“We will sort the relationship issues through couple therapy and the foreplay issues through sex coaching,” I explained on how we were to sort out her problems. 

“I would like to first deal with the biological issues around the care for your vagina,” I told her.

As a sexologist, I am perturbed that most women are not keen on taking care of their vaginas. Throughout the life of a woman, the vagina faces an assault of sorts. There are periods of dryness, which are quite predictable, but are ignored. With dryness comes physical injuries from sex, repeated infections, repeat assaults by having more penetrative sex even before healing happens; and opportunistic infections such as vaginal thrush which causes itchiness.

“Ok doctor, you have made your point, just tell me what you need me to do as a way of care,” Rispa said, realising that I was getting emotional about the subject.

Well, during the dry spells, your first weapon is vaginal moisturisers. The same way one is so keen to keep the face moisturised is the same way the vagina should be treated. Moisturisers come in form of creams which are applied locally to the vagina and keep the vagina moist and with the right Ph. Dryness is accompanied by change in Ph to a more alkaline state and this is what makes it easy for infections to attack the vaginal lining. A normal acidic vagina fights local infections quite well.

Secondly, there should be no restriction as to the use of lubricants during sex. Always keep a lube next to your bed, or carry it in your bag, you never know when it will be needed. Use it as the situation demands. Be sure to choose a lubricant that doesn't contain petroleum jelly or glycerin.

Thirdly, a vibrator may be necessary to augment foreplay. There is a period in the cycle of a woman when irrespective of whatever is done one she remains dry. Couples these days use a vibrator to increase their arousal as a way of avoiding dry and painful sex.

“I’m not sure my husband can tolerate that,” Rispa noted, “he most likely will see the vibrator as a competitor,” she added.

And yes, use of vibrators and other sex toys is quite controversial given the moral and cultural reservations that people hold around them. It is important that a couple agrees on their use beforehand.

The fourth weapon to fight dryness is hormonal creams. These are safe when applied locally in the vagina and help tissues regenerate, improving vaginal health. A healthy vagina lubricates easily.

Your fifth but equally important weapon is pelvic physiotherapy. You need to learn to relax your pelvis and control the muscles therein. This is what sexual health pelvic physiotherapy achieves. A tense pelvis increases pain during sex.

The sixth weapon is managing communication when sex becomes dry and painful. Partner support in managing the situation is very important. Communication however needs to be constructive. A conflict like what Rispa was going through is never helpful in resolving the situation.

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