by Dympna Cole, MD

A common symptom of menopause is lack of vaginal moisture. This occurs due to a low level of estrogen and can lead to problems such as urinary tract infections, vaginal infections and pain with intercourse (dyspareunia).

Although over-the-counter moisturizers and lubricants may help to relieve symptoms they do not address the underlying cause: lack of estrogen. While systemic hormone replacement therapy (HRT) can help to alleviate problems related to vaginal dryness, it is associated with increased risk of breast and uterine cancer. It is not a long-term solution. A safer and more direct approach is the use of vaginal estrogen therapy. This is available in the form of cream and tablets and is typically dosed twice per week with the use of an applicator. Vaginal estrogen rings are also available but are considered systemic therapy and must be prescribed along with progesterone if you still have a uterus.

Symptoms of vaginal dryness, also known as atrophic vaginitis, typically improve six weeks after initiating vaginal estrogen therapy. To avoid recurrence of symptoms therapy should be continued twice per week.

For women who are not candidates for vaginal estrogen therapy, perhaps due to a history of breast cancer, there is a hormone-free option. This comes in the form of a vaginal suppository that is placed every 2 to 3 days. The suppository is derived from hyaluronic acid, which occurs naturally in our bodies.

If you are experiencing difficulty with lack of vaginal moisture call today to schedule a consultation to determine what treatment option is best for you!