It’s a common problem that only gets worse during the menopause transition; yet, no one wants to talk about it, and even fewer women are doing anything to correct it. A new study identifies those factors that contribute to the taboo problem of vaginal dryness. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Many women experience vaginal dryness during menopause, which often manifests as burning, itching, or lack of lubrication during sexual activity, and they have a lot of company. Data from the Study of Women Across the Nation (SWAN) tracked more than 2,400 women over a 17-year-period showed that, at baseline, 19.4% of women (aged 42-53 y) reported vaginal dryness. By the time the women in the study were aged 57 to 69 years, 34% of them complained of symptoms.

More surprising, however, is the fact that more than 50% of women don’t report vaginal dryness to their healthcare providers, and less than 4% of affected women are actively using any of the many proven therapies that include vaginal estrogen tablets, creams, and rings, according to “Factors associated with developing vaginal dryness symptoms in women transitioning through menopause: a longitudinal study,” the Menopause article detailing the study results.

It’s no secret that as a woman transitions through menopause and her estradiol levels drop, her body undergoes many changes. Among these changes is decreased vaginal blood flow, which leads to vaginal dryness and pain during intercourse. In addition to highlighting the problem of women not talking about symptoms or acting to help manage the problem, the new study demonstrates that the frequency of sexual activity has no effect on the degree of vaginal dryness or pain during intercourse. So, women who were having either more or less sex specifically because they thought it would cure their problem will have to look for more proven treatment options. Additionally, the study found that hormone therapy was much more effective at managing vaginal dryness in women who experienced natural menopause than in those who underwent a hysterectomy.

“Studies have confirmed that although more than half of women develop vaginal dryness as they become more postmenopausal, most do not report symptoms. Some will try lubricants as they begin to develop pain with sex,” says Dr. JoAnn Pinkerton, NAMS executive director. “However, if lubricants and vaginal moisturizers are not enough, there are highly effective vaginal therapies such as vaginal estrogen tablets, creams, the low-dose ring, and the new intravaginal dehydroandrosterone. It’s shocking that less than 4% of women in the SWAN study were using these effective therapies by the end of the study period. For women, please report symptoms, and for healthcare providers, please offer safe, effective therapies.”