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Vaginal estrogen: A low-dose option for treating menopause symptoms

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Posted by Alex Daly on Aug. 5, 2019

During menopause, when the amount of estrogen in a woman’s body declines, uncomfortable changes can happen in the vagina. These changes can include inflammation, dryness, itchiness, and pain during intercouse. 

Low-dose vaginal estrogen, which is available with a doctor’s prescription, can help alleviate these symptoms by restoring small doses of estrogen to the body. Read on to learn about the benefits and risks, and whether this treatment may be right for you.

What is vaginal estrogen?

Vaginal estrogen products are commonly used by women experiencing vaginal perimenopause or menopause symptoms. Vaginal estrogen restores vaginal blood flow and improves the dexterity of vaginal tissue, bringing relief for bothersome symptoms in the process.

During a woman’s childbearing years, estrogen levels are higher. As menopause begins, estrogen levels decrease, causing changes in the vaginal tissue and the lower part of the urethra. 

Vaginal estrogen products help that tissue stay flexible, which is crucial during sexual intercourse. The products also help prevent urinary tract infections, and work to reverse the uncomfortable tissue thinning and vaginal dryness that occurs as women age. Lubricants and moisturizers provide temporary relief, but vaginal estrogen products go a step further, and provide a long-term solution.

What are the advantages of vaginal estrogen?

For women who have vagina-specific menopause symptoms, vaginal estrogen has a number of advantages. The concentration of the product allows it to be used only where it is needed, consequently minimizing possible side effects of estrogen on the rest of the body. Doctors agree that vaginal estrogen should be used at the lowest effective dose in order to limit its effect elsewhere in the body. 

One recent study showed that the use of low-dose vaginal estrogen is not associated with a higher risk of cardiovascular disease or cancer (two concerns with other types of hormone therapy). 

Another study that followed 50,000 post-menopausal women over 10 years, comparing women who used vaginal estrogen to those who didn’t, found no increase in the risk of breast cancer, heart disease or blood clots. 

Still, some studies do show a correlation between estrogen therapy and breast cancer, so prior to using estrogen in any form (even low-dose vaginal estrogen), it’s important to speak  to your doctor. It is crucial to mention any personal or family history of breast cancer before using estrogen in any form.  

What symptoms does vaginal estrogen treat? 

Vaginal estrogen treats genital and urinary issues (commonly known as the genitourinary syndrome of menopause), such as vaginal burning and irritation, lack of lubrication, and pain during intercourse, which affect between 25 percent and 70 percent of women who’ve gone through menopause.

According to the results of a recent study, roughly 93 percent of women who took vaginal estrogen reported significant improvement in their symptoms. 

Improvement can occur within a few weeks of starting treatment, but if the condition is severe, it can take several months to make a noticeable difference.

Other uses for vaginal estrogen, according to the Mayo Clinic, include:

  • Treating vaginal dryness or soreness 
  • Alleviating iItching or irritation of the vulva
  • Lessening feelings of pain during urination or the desire to urinate more often than necessary 

What are the treatment forms of vaginal estrogen? 

Most often, vaginal estrogen is prescribed in very small doses, usually in one of these forms:. 

  • Vaginal soft-gel or tablet that is inserted into the vagina
  • Topical cream that is applied several times a week directly in the vagina 
  • Low-dose vaginal ring that is inserted into the vagina for three months at a time 

Any of these treatment forms can be helpful, depending on your condition. No matter which form you and your doctor choose, there tend to be few side effects of vaginal estrogen due to how locally the estrogen is administered. 

If you're experiencing menopause or postmenopausal symptoms, like vaginal dryness or painful intercourse, doctors are available online to consult with you, privately and conveniently. Your doctor can help you decide if low-dose vaginal estrogen is a treatment option that makes sense for your condition. 

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