Vaginal dryness is a significant problem after menopause. Vaginal
dryness is caused by vaginal atrophy which is a thinning and drying of
the vaginal walls. This is, in turn, causes inflammation and often
results in painful or difficult sexual relations. The dryness is created
by a lack of estrogen.
How do we treat vaginal dryness?
1. Try any lubricant you may have at home, be creative! You can use KY jelly, coconut water, vegetable oil, hand lotion etc. If these are unsuccessful then the next option is medical intervention.
2. Medical options can be divided into hormonal and non-hormonal options.
Hormonal options for vaginal dryness treatment include estrogen. If there are not any symptoms of hot flashes then vaginal estrogen is the preferred hormonal choice for management of vaginal dryness. Vaginal estrogen can be inserted as a cream, a tablet or a ring. There are 2 vaginal creams on the market Estrace and Premarin. Both of these are used 1-2 times weekly. Vaginal tablets are available as Vagifem and are inserted twice weekly. Estring is a small ring inserted into the vagina and it remains there for 3 months and then it is changed by the user.
Vaginal estrogen is only minimally absorbed into the systemic circulation. However, there are many patients who cannot or do not want to use any form of estrogen due to their concern of cancer or blood clots. If that is the preference then there or non-hormonal treatments.
Non-hormonal vaginal dryness treatment is available.
There are 2 options for the patient who prefers not to use hormones: a pill and a laser.
Oshima is a daily pill. It is a SERM, serum estrogen receptor modulator. This means in some tissue it mimics estrogen and in other tissues, it antagonizes estrogen. In the vagina and the bones, it mimics estrogen and increases vaginal lubrication and improves bone health. In the breast, it inhibits breast proliferation and reduces breast cancer. However, in the vascular circulation, it increases thrombosis and blood clots.
3. There is now an exciting new option for vaginal dryness treatment. It is a vaginal laser. This laser requires 3 treatments, all of which are painless. This is a 100% hormone free treatment. After use of the laser, the vagina is rejuvenated and lubrication is restored making sexual relations more comfortable. Each treatment takes less than 5 minutes. The treatment lasts for 12-24 months and then requires a quick annual touchup. To date there have been no major complications and there is in excess of an 85% success rate.
Sex does not have to end because of menopause. It should still be fun. Investigate your options and learn about all the different ways to manage vaginal dryness treatment.
How do we treat vaginal dryness?
1. Try any lubricant you may have at home, be creative! You can use KY jelly, coconut water, vegetable oil, hand lotion etc. If these are unsuccessful then the next option is medical intervention.
2. Medical options can be divided into hormonal and non-hormonal options.
Hormonal options for vaginal dryness treatment include estrogen. If there are not any symptoms of hot flashes then vaginal estrogen is the preferred hormonal choice for management of vaginal dryness. Vaginal estrogen can be inserted as a cream, a tablet or a ring. There are 2 vaginal creams on the market Estrace and Premarin. Both of these are used 1-2 times weekly. Vaginal tablets are available as Vagifem and are inserted twice weekly. Estring is a small ring inserted into the vagina and it remains there for 3 months and then it is changed by the user.
Vaginal estrogen is only minimally absorbed into the systemic circulation. However, there are many patients who cannot or do not want to use any form of estrogen due to their concern of cancer or blood clots. If that is the preference then there or non-hormonal treatments.
Non-hormonal vaginal dryness treatment is available.
There are 2 options for the patient who prefers not to use hormones: a pill and a laser.
Oshima is a daily pill. It is a SERM, serum estrogen receptor modulator. This means in some tissue it mimics estrogen and in other tissues, it antagonizes estrogen. In the vagina and the bones, it mimics estrogen and increases vaginal lubrication and improves bone health. In the breast, it inhibits breast proliferation and reduces breast cancer. However, in the vascular circulation, it increases thrombosis and blood clots.
3. There is now an exciting new option for vaginal dryness treatment. It is a vaginal laser. This laser requires 3 treatments, all of which are painless. This is a 100% hormone free treatment. After use of the laser, the vagina is rejuvenated and lubrication is restored making sexual relations more comfortable. Each treatment takes less than 5 minutes. The treatment lasts for 12-24 months and then requires a quick annual touchup. To date there have been no major complications and there is in excess of an 85% success rate.
Sex does not have to end because of menopause. It should still be fun. Investigate your options and learn about all the different ways to manage vaginal dryness treatment.
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