Q: I’m 23, and I have unusual vaginal dryness. I just stopped using Depo-Provera and began birth control pills (orthotricyclen). I use a lubricant two times a day as directed by my doctor, but I get extremely dry during intercourse, to the point where it hurts. Is there anything you could recommend?
A: Vaginal dryness is major problem for many women. Occasionally, women have a problem with dryness if their estrogen levels are suppressed from being on the medication, but it doesn’t happen often. Switching to orthocyclen was a good idea for you because orthocyclen contains estrogen, which is responsible for maintaining vaginal secretions.
Recommendations for vaginal dryness
I have seen women experience vaginal dryness even while taking estrogen-containing birth control pills, and for them it is worthwhile to stop taking the pill altogether for a few months to see if lubrication resumes.
Of course, it is important to rule out a vaginal infection as the cause of the dryness. Yeast infections are notorious for drying the vagina, and they do not always alert you with the classic itching symptoms.
There are two other approaches to the dryness problem. Topical lubricants are fine for women of any age to help with intercourse. Some patients seem to prefer Astroglide. It is a glycerin-based lubricant, which is not messy and is available at pharmacies without a prescription. There are also prescription vaginal estrogen preparations, which deliver estrogen directly to the target tissue. There are vaginal creams, such as Premarin or Estrace, and there is a ring, called the Estring, that can be inserted into the vagina to enhance lubrication. The creams are inserted with an applicator on a day when you won’t be having intercourse. The Estring is a small estrogen-coated rubber ring, which can be left in the vagina for three months at a time and slowly secretes a small amount of estrogen to help with lubrication.
So, one way or another, there is help for you and all other women experiencing vaginal dryness, regardless of age.