Hormone Therapy and Vaginal Dryness

“If you are bothered only by vaginal dryness,
you can use very low doses of estrogen
placed directly into the vagina”.1

Umbrella
What may the Hormone Therapy and Vaginal Dryness Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Atrophic Vaginitis
  • Genital Atrophy
  • Genitourinary Syndrome of Menopause
  • Hormone Replacement Therapy (HRT)
  • Hormone Therapy (HT)
  • Local Low-Dose Estrogen Therapy
  • Menopausal Hormone Therapy (MHT)
  • Vaginal Atrophy
  • Vaginal Dryness
  • Vaginal Estrogen/Oestrogen
  • Vaginal Symptoms
  • Vulvovaginal Atrophy

Vaginal Dryness

What is vaginal dryness?

DotS the definition of vaginal dryness may vary. In Vaginal Dryness After Menopause: How To Treat It? I’m postmenopausal and often have vaginal dryness, which makes intercourse painful. Is there anything I can do about it? the (United States) Mayo Clinic’s definition is:

“Vaginal dryness can be a problem for many postmenopausal women. Vaginal dryness is a hallmark sign of the genitourinary syndrome of menopause, also known as atrophic vaginitis or vaginal atrophy. With this condition, vaginal tissues become thinner and more easily irritated — resulting from the natural decline in your body’s estrogen levels during menopause”.2

Vaginal Estrogen

What is vaginal estrogen?

DotS the definition of vaginal oestrogen may vary. In Hormone Replacement Therapy (HRT): Vaginal Oestrogen: About Vaginal Oestrogen the NHS definition is:

“Vaginal oestrogen is a hormone replacement therapy (HRT) medicine that contains the hormone oestrogen. It’s used to treat the vaginal dryness and irritation that can happen during the menopause”.3

On page one in Deciding About Hormone Therapy, published July 2022, the North American Menopause Society (NAMS) explain:

“If you are bothered only by vaginal dryness, you can use very low doses of estrogen placed directly into the vagina. These low doses generally do not raise blood estrogen levels above postmenopause levels and do not treat hot flashes. You do not need to take a progestogen when using only low doses of estrogen in the vagina. (The MenoNote “Vaginal Dryness” covers this topic in detail)”.4

Cream, Tablet, Pessary or Ring

How can estrogen be applied directly to the vagina?

In Vulvovaginal Atrophy: Topical Vaginal Estrogens the European Menopause and Andropause Society explain:

Hormone Therapy and Vaginal Dryness

  • “These may contain estradiol, estriol, promestriene and conjugated estrogens
  • Preparations include tablets, rings, capsules, creams, gels and ovules
  • Most are low-dose and do not change systemic estrogen levels
  • There is no need to add progestogen (for endometrial protection) when low-dose topical estrogens are used
  • They can be used alone or with systemic menopausal hormone therapy
  • They may also improve urinary incontinence and prevent recurrent urinary tract infections
  • They do not increase the risk of endometrial cancer, breast cancer, venous thromboembolism or cardiovascular disease”.5

Duration

How long can vaginal estrogen be used for?

On page three and four in the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause, first published online 10 June 2022, one of the recommendations is:

  • “Low-dose and ultra-low dose vaginal oestrogen preparations can be taken by perimenopausal and menopausal women experiencing genitourinary symptoms and continued for as long as required. All vaginal oestrogen preparations have been shown to be effective in this context and there is no requirement to combine vaginal oestrogens with systemic progestogen treatment for endometrial protection, as low-dose and ultra-low dose vaginal oestrogen preparations do not result in significant systemic absorption or endometrial hyperplasia”.6

Compounded Vaginal Estrogen and Testosterone

Are compounded vaginal estrogen and testosterone recommended?

On page two in Vaginal Dryness, published November 2022, the NAMS include:

“Notes: Compounded vaginal estrogen and testosterone are not FDA regulated or recommended for treatment of GSM in most cases”.7

What is FDA?

FDA in this context, is an abbreviation for the (United States) Food and Drug Administration.

What is GSM?

GSM in this context, is an abbreviation for the Genitourinary Syndrome of Menopause.

Health Care Provider

What if my vaginal symptoms do not improve with treatment?

On page two in Vaginal Dryness, published November 2022, the NAMS explain:

“Notes: Vaginal and vulvar symptoms not related to menopause include yeast infections, allergic reactions, and certain skin conditions, so consult your healthcare professional if symptoms do not improve with treatment”.8

Health Topics A-Z

Where may I find Health Topics A-Z related to Hormone Therapy and Vaginal Dryness?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

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New or Updated

  1. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  2. BMS & WHC’s 2020 Recommendations on Hormone Replacement Therapy In Menopausal Women
  3. BMS TV: Bioidentical Hormones
  4. BMS TV: Hormone Replacement Therapy (HRT)
  5. BMS TV: Testosterone Explained
  6. BMS TV: Urogenital Atrophy
  7. Bioidentical Hormones: Are They Safer?
  8. Caredownthere
  9. Consumer Health: Treating Vaginal Dryness After Menopause
  10. Deciding About Hormone Therapy
  11. Deciding About Hormone Therapy Use
  12. Easier Access To Locally Applied HRT To Treat Postmenopausal Vaginal Symptoms In Landmark MHRA Reclassification [British Menopause Society]
  13. Easier Access To Locally-Applied HRT To Treat Postmenopausal Vaginal Symptoms In Landmark MHRA Reclassification [Medicines & Healthcare Products Regulatory Agency, GOV.UK]
  14. Endometrial Safety of Low-Dose Vaginal Estrogens
  15. Endometrial Safety of Low-Dose Vaginal Estrogens [Video]
  16. Estradiol Vaginal Cream
  17. Estrogen (Vaginal Route): Before Using
  18. Estrogen (Vaginal Route): Description and Brand Names
  19. Estrogen (Vaginal Route): Precautions
  20. Estrogen (Vaginal Route): Proper Use
  21. Estrogen (Vaginal Route): Side Effects
  22. Estrogen Vaginal
  23. Experiencing Vaginal Dryness? Here’s What You Need To Know
  24. FAQs: Vulvovaginal Health
  25. HRT
  26. HRT – Types, Doses and Regimens
  27. HRT: Benefits and Risks
  28. Hormone Replacement Therapy (HRT): Vaginal Oestrogen
  29. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – About Vaginal Oestrogen
  30. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – Common Questions About Vaginal Oestrogen
  31. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – How and When To Use Vaginal Oestrogen
  32. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – Side Effects of Vaginal Estrogen
  33. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – Using Vaginal Oestrogen With Other Medicines and Herbal Supplements
  34. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – Who Can and Cannot Use Vaginal Oestrogen
  35. Hormone Therapy: Is It Right for You?
  36. How Do I Deal With Vaginal Atrophy? — Ask Dr Jean
  37. I Forgot To Ask the Doctor – E9: The Menopause. Can Every Woman That Wants It Have HRT?
  38. International Society for the Study of Women’s Sexual Health: Find A Provider
  39. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause
  40. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Sexual Wellbeing, Intimacy and Menopause [+ Video: Menopause Is the End of Your Sex Life]
  41. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Signs and Symptoms of Menopause [+ Video: Talking Menopause With Your GP]
  42. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Supporting Someone Through the Menopause [+ Video: Men Don’t Need To Know About Menopause]
  43. Let’s Talk About Perimenopause
  44. Looking After Yourself: Sex and Relationships
  45. Lubricant Alternatives: What To Use and What To Avoid
  46. Managing Your Symptoms: Managing Bladder, Vaginal and Vulval Problems
  47. Mayo Clinic Q and A: Treatment for Vaginal Dryness for Menopausal Women
  48. Menopause
  49. Menopause
  50. Menopause
  51. Menopause
  52. Menopause Map: Downloadable Resources – My Personal Path Print Tools – Questions for Your Health Care Provider
    Hormone Therapy and Vaginal Dryness
  53. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  54. Menopause Patient Information [Videos] 4. The Different Types of HRT
  55. Menopause Preparedness Toolkit Video Series: Common Conditions Associated With Menopause and Midlife
  56. Menopause Preparedness Toolkit: A Woman’s Empowerment Guide
  57. Hormone Therapy and Vaginal DrynessMenopause Ruining Your Sex Life?
  58. Menopause Symptoms: Mayo Clinic Expert Outlines Hormone and Nonhormonal Therapies
  59. Menopause Treatments: What Works, What Doesn’t – Treatments for Vaginal Dryness
  60. Menopause: Things You Can Do
  61. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  62. Mymenoplan.org [My Menoplan, United States]
  63. Navigating Menopause Together: How Partners Can Help
  64. Navigating Menopause: Expert Insights and Solutions | Dr Susan Davis | The Proof Podcast EP 245
  65. Patty Brisben Foundation for Women’s Sexual Health: Guide To Sexual Health Providers
  66. Perimenopause and Menopause Symptom Checklist
  67. Position Statement for Management of Genitourinary Syndrome of the Menopause (GSM)
  68. Prosayla Supported By ISSWSH [International Society for the Study of Women’s Sexual Health]
  69. Public Assessment Report – Prescription Only Medicine To Pharmacy Reclassification – Gina 10 Microgram Vaginal Tablets
  70. Risks and Benefits of MHT
  71. Supporting A Loved One Through Menopause
  72. The 2020 Genitourinary Syndrome of Menopause Position Statement of The North American Menopause Society
  73. The North American Menopause Society Releases Its 2022 Hormone Therapy Position Statement
  74. The Truth About Menopause Supplements | Dr Sarah Berry
  75. Therapy for the Effects of Menopause
  76. Tips To Help Manage Menopause Symptoms
  77. Topical Estrogens and Non-Hormonal Preparations for Postmenopausal Vulvovaginal Atrophy: An EMAS Clinical Guide
  78. Urogenital Problems
  79. Urologic View In the Management of Genitourinary Syndrome of Menopause
  80. Using Natural Therapies In the Menopause Transition – Webinar
  81. Vaginal Atrophy
  82. Vaginal Dryness
  83. Vaginal Dryness
  84. Vaginal Dryness
  85. Vaginal Dryness After Menopause: How To Treat It? I’m postmenopausal and often have vaginal dryness, which makes intercourse painful. Is there anything I can do about it?
  86. Vaginal Dryness Alternative Treatments
  87. Vaginal Dryness: Treatment Options
  88. Vaginal Dryness: What To Do About It
  89. Vaginal Oestrogen
  90. Vaginal Laser Therapy for GSM/VVA: Where We Stand Now – A Review By the EUGA Working Group on Laser
  91. Video Series-2022: Hormone Therapy: Understanding the Risks and Benefits
  92. Video Series-2023: NAMS 2023 Nonhormone Therapies Position Statement for Bothersome Menopause Symptoms
  93. Video Series-2024: Preparing for Your Menopause Health Care Visit
  94. Videos and Podcasts: Videos – Interviews: A Simple Approach To Menopause: The Menopause Quick Six (www.MQ6.ca)
  95. Videos and Podcasts: Videos – Interviews: Vulvovaginal Atrophy
  96. Vulva and Vaginal Health: Getting the Right Advice
  97. Vulvovaginal Atrophy
  98. Webinars: Previous – Genitourinary Syndrome of Menopause
  99. Why Didn’t Anyone Tell Me This? Episode 3: Dr Annice Mukherjee: Your Essential Menopause Toolkit
  100. Wild Yam

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Deciding About Hormone Therapy Use. 2022:1 North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 12 April 2024
  2. Vaginal Dryness After Menopause: How To Treat It? I’m postmenopausal and often have vaginal dryness, which makes intercourse painful. Is there anything I can do about it? 07 December 2022. Mayo Clinic https://www.mayoclinic.org/vaginal-dryness-after-menopause/expert-answers/faq-20115086 Accessed: 12 April 2024
  3. Hormone Replacement Therapy (HRT): Vaginal Oestrogen: About Vaginal Oestrogen. Page Last Reviewed: 27 January 2023. NHS https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/vaginal-oestrogen/about-vaginal-oestrogen/ Accessed: 12 April 2024
  4. Deciding About Hormone Therapy Use. 2022:1 North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 12 April 2024
  5. Vulvovaginal Atrophy: Topical Vaginal Estrogens. 2022. European Menopause and Andropause Society https://emas-online.org/wp-content/uploads/2022/07/Vulvovaginal-atrophy.pdf Accessed: 12 April 2024
  6. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022:3-4. https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 12 April 2024
  7. Vaginal Dryness: Note. 2022: 2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 12 April 2024
  8. Vaginal Dryness: Note. 2022: 2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 12 April 2024
Topic Last Updated: 12 April 2024 – Topic Last Reviewed: 12 April 2024

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