Sécheresse vaginale

Insufficient vaginal lubrication leads to urinary discomfort, vaginal itching and pain during sexual intercourse (dyspareunia) ^{(MedlinePlus 2017)}. The most common cause is oestrogen deficiency ^{(MedlinePlus 2017)} leading to transient or permanent atrophy or hypotrophy of the vaginal wall.

It can occur in diseases such as multiple sclerosis ^{(Cordeau 2014)}, diabetes ^{(Carati 2016)}, Sjögren's syndrome ^{(Romão 2018)}, endometriosis, depression, stress, some anticancer and hormonal drugs (e.g. tamoxifen), pelvic radiotherapy, menopause ^{(MedlinePlus 2017)} and in 17-83% of breastfeeding mothers during the first weeks/months and/or amenorrheic phase of breastfeeding. ^{(Perelmuter 2025, Sun 2024, Szablewska 2023, Lev 2020, Alp 2019, O'Malley 2018, Saotome201, Rezaei 2017, Wallwiener 2017, Lagaert 2017, Agarwal 2015, Anzaku 2014, Solana 2008, Palmer 2003, Barrett 2000, Kayner 1983)}

Several studies have found no association of postpartum sexual dysfunction with breastfeeding:

• In a study in 2024 in 353 Polish mothers in the first two postpartum years, 84.71% reported sexual dysfunction in the breastfeeding group and 78.31% in the formula feeding group; lubrication problems and lack of sexual desire were the most frequent dysfunctions, but were independent of feeding type. ^{(Szablewska 2023)}
• Another study in 86 Japanese women found sexual dysfunction and lubrication problems at 1 and 3 months postpartum that improved between 6 and 12 months and was unrelated to breastfeeding type. ^{(Saotome2018)}
• In a Spanish study of 117 mothers there was 90% sexual dysfunction, but no association with breastfeeding was found. ^{(Hidalgo 2022)}

No articles have been found that study sexual dysfunction in breastfeeding according to whether or not there is amenorrhoea, nor in the case of prolonged breastfeeding for more than two years.

Irritating soaps and perfumes should be avoided. The treatments used, whether non-hormonal (water-based lubricants, hyaluronic acid ^{(Stute 2013)} or topically applied non-hormonal vaginal moisturisers such as creams, gels or ova), whether topical oestrogens ^{(Zsolnai 1982)} or systemic oestrogens, are compatible with breastfeeding.

Oestrogens have a high (98%) binding to plasma proteins ^{(O'Connell 1995)}, so they are not excreted in breast milk in significant amounts; they also have very low (< 10%) oral absorption ^{(O'Connell 1995)}. Vaginal absorption of oestrogens can be minimised by using low/minimal doses or certain preparations ^{(Santen 2015, Del Pup 2013 and 2012, Tan 2012, Bhamra 2011, Eugster 2010)}. No decrease in milk production was observed in a mother treated with vaginal oestrogen cream. ^{(Palmer 2003)}

To maintain sexual health and promote breastfeeding, aspects of perinatal sexuality need to be routinely included in antenatal classes; women and their partners should receive comprehensive and professional counselling on postpartum sexuality, the factors that may affect it and how to address them. ^{(Szablewska 2023, O'Malley 2018, Wallwiener 2017)}

See below the information of these related products:

• Estradiol (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
• Hyaluronic Acid (Safe product and/or breastfeeding is the best option.)
• Non-Hormonal Vaginal Lubricant (Safe product and/or breastfeeding is the best option.)
• Promestriene (Safe product and/or breastfeeding is the best option.)
• Sexual intercourse (Safe product and/or breastfeeding is the best option.)