The human body, particularly in women, is composed of approximately 40-60% water. When this percentage decreases, the body sends out distress signals. A simple example is experiencing dryness in the mouth and throat and feeling thirsty. Drinking water replenishes the lost moisture and resolves the issue. However, some organs require vigilant attention, as they may become dry without any apparent symptoms until the condition becomes severe. One such organ is the vagina. The reduction in the vaginal mucosal tissue is referred to as 'vaginal dryness,' typically caused by the decrease in blood flow around the uterus and vagina.

According to a report released by Women's Health Concern (WHC), about 17% of British women aged 18 to 50 claim to experience discomfort during intercourse due to vaginal dryness. Moreover, a survey conducted in the US by Dr. Kausar revealed that 20% of respondents are receiving treatment for vaginal dryness. If we take into account the women who do not seek medical help due to ignorance about the condition or feelings of embarrassment, it is estimated that almost 50% of women suffer from vaginal dryness. In Korea, young female patients seeking help for vaginal dryness at women's health clinics are rising. This condition affects women of all ages, irrespective of menopause.

Symptoms

If the glands in the female reproductive system do not function properly, there is a reduction in the natural vaginal discharge. This decrease causes dryness in the vagina. Vaginal discharge, which is slightly acidic, contains antibodies that block and eliminate foreign viruses or pollutants that invade the body. It also acts as a natural lubricant, mitigating friction during intercourse and protecting the reproductive organs. Therefore, a decrease in vaginal discharge leading to dryness results in the following issues:

• Frequent urge to urinate and discomfort during urination.
• Swelling and heat in the perineum area when walking.
• Intense itching due to frequent injuries inside the vagina.
• Increased susceptibility to bacterial infections, leading to frequent vaginitis or cystitis.
• Severe pain during intercourse, which could cause bleeding in extreme cases.
• Disruption of the vaginal environment, which usually maintains an acidity level between pH 4.0 and 5.0.

While dryness alone can cause discomfort, reduced vaginal discharge can lead to complications like urinary incontinence and uterine prolapse. Furthermore, vaginal dryness affects not only a woman's everyday life but also her sexual relationship with her partner, potentially leading to mental distress, such as depression. Therefore, proper care of vaginal health is paramount.

Causes

Vaginal dryness is traditionally considered a symptom of perimenopause - a natural stage of aging. As women age, the levels of the hormone estrogen decrease, which affects the body's ability to keep the vagina moist and healthy. As estrogen levels decrease, the vaginal walls thin out, and dryness ensues. However, considering the recent prevalence of vaginal dryness among all age groups, it cannot be attributed solely to perimenopause. Factors affecting estrogen levels that should be considered include 

• childbirth and breastfeeding
• ovarian removal surgery or early menopause
• taking medication that artificially controls hormones:

steroids, the ovulation inducer clomiphene, obesity treatment or contraceptive pills weakening ovarian function, anti-estrogen drugs used for treating breast cancer or endometriosis

• excessive stress, and diet leading to hormonal imbalance.

In addition, excessive smoking, depression, fatigue, and chronic autoimmune diseases like Sjögren's syndrome, are known to cause vaginal dryness. 

Conclusion

Vaginal dryness requires consistent management as it can become chronic if not treated in the initial stages. While hormonal treatment can temporarily increase depleted estrogen levels, it's artificial and emphasizes the importance of everyday habits for vaginal health. To manage this, regular visits to a gynecologist for periodic check-ups and familiarizing oneself with one's body are necessary. Regular exercise to relieve stress, and consuming 1.5L to 2L of water a day (as recommended by the World Health Organization) to hydrate are essential. Particularly, it's advised to avoid habits such as drinking, smoking, and consuming caffeine which significantly deplete body moisture. Additionally, washing the vulva with water or a cleanser with a similar pH to the vagina and wearing well-ventilated cotton underwear can also be helpful.