“Of the estimated 32 million women in the U.S. who have vaginal atrophy, only seven percent receive prescription treatment.”
It’s a fact of life that nearly every post-menopausal women will experience vaginal atrophy, a chronic condition that causes discomfort and sexual dysfunction due to a natural decline in estrogen at menopause. The symptoms include vaginal dryness, resulting from the thinning and inflammation of the vaginal walls, burning and itching in and around the vagina, urinary problems and painful intercourse. Naturally, these uncomfortable symptoms can impact a woman’s quality of life and put a strain on her relationship with her partner.
Sadly, despite the availability of safe and effective products for vaginal atrophy, most women with this condition are reluctant to seek treatment because they’re embarrassed talking about this very private problem with their gynecologist. In fact, in a presentation on “vaginal aging” by Dr. Michael Krychman, at the recent conference of the North American Menopause Society (NAMS), I learned that of the estimated 32 million women in the U.S. who have vaginal atrophy, only seven percent receive prescription treatment.
Clearly, it’s time for women to speak up and ask for help in selecting the right treatment for her symptoms. There are many options include systemic hormone therapy, local vaginal estrogen, and a range of lubricants and moisturizers that can be used alone or in combination with hormone therapy. Your physician can help you determine the best way to go. Here’s a brief summary of what you have to choose from:
Local Estrogen – With this approach, a low dose of estrogen is delivered to the vagina, with minimal absorption to the rest of the body. A prescription is required and the amount of estrogen in each product varies. There are three options: you can use a cream such as Estrace; a tablet called VagiFem; or a soft, flexible ring called Estring, which must be changed every three months by you or your physician. When using a local estrogen cream or tablet, the recommended approach, according to Dr. Lauren Streicher, a Chicago gynecologist and expert contributor to the Dr Oz Blog, is to begin with daily use for 14 days followed by maintenance therapy twice weekly. “I have many patients with miild atrophy that do well with once weekly dosing, but that is not standard protocol,” she said.
There are also many estrogen-free, lubricants and moisturizers that can help relieve pain during intercourse. These over-the-counter products are available in liquid or gel form and are applied directly to the vagina and vulva. They’re particularly good for women who cannot or do not want to use local estrogen therapy.
Most lubricants such as Astroglide, K-Y Jelly, and FemGlide provide only short term, temporary help during sex. If dryness is a recurring complaint, a long-lasting vaginal moisturizer such as Replens, Hyalo Gyn, or Luvena Prebiotic might be a better choice for immediate and long-lasting moisture and relief. They are applied regularly every three or four days. (For a limited time, you can receive a free sample of Replens. Click here for information.)
As “Shmirshky” author Ellen Dolgen always says, “Reaching out is IN! Suffering in silence is OUT! So if you’re experiencing any of the symptoms I’ve described, do yourself a BIG favor and make an appointment with your gynecologist and decide together which of these treatments would be best for you.