Gynecologic Cancer Awareness Month 2024 is held in September. Is September the month for your annual Well Women Visit?

Gynecologic Cancers

What are gynecologic cancers?

Depending on the Source, the definition of gynecologic cancers may vary. In Gynecologic Cancer Awareness the (United States) Centers for Disease Control and Prevention’s definition is:

“Gynecologic cancers are cancers of women’s reproductive organs”.

Five Types

What are the five types of gynecologic cancers?

In Gynecologic Cancer Basics the (United States) Foundation for Women’s Cancer explain:

“The five types of gynecologic cancers are ovarian, endometrial/uterine, cervical, vulvar and vaginal cancer”.

Postmenopausal Bleeding

Is postmenopausal bleeding or bleeding after menopause, normal or not?

No. In Postmenopausal Bleeding the (United Kingdom) NHS elaborate on:

“See a GP if:

You have postmenopausal bleeding, even if:

  • It’s only happened once
  • There’s only a small amount of blood, spotting, or pink or brown discharge
  • You do not have any other symptoms
  • You’re not sure if it’s blood.

Postmenopausal bleeding is not usually serious, but can be a sign of cancer. Cancer may be easier to treat if it’s found early”.

Who is a GP?

Depending on the Source and/or Depending on the Country, a GP may be a qualified and registered general practitioner, a medical practitioner, a medical doctor or a doctor.

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Last Updated: 04 September 2024 – Last Revised: 30 August 2024

Vaginal Atrophy, Lubricants, Moisturizers, Oestrogen, More showcases evidence-based information by Menopause Societies and International Sources.

Common or Not

How common is vaginal atrophy?

In Vaginal Atrophy: What Is Vaginal Atrophy? the (Australian) Jean Hailes for Women’s Health (JH) explain:

Vaginal Atrophy, Lubricants, Moisturizers, Oestrogen, More“Vaginal atrophy is the thinning of your vaginal lining and vulval skin, caused by a drop in oestrogen levels around the time of menopause. Vaginal atrophy affects about 40% of postmenopausal women – and the risk increases with age.”

Vaginal Atrophy Treatment Options

What are some vaginal atrophy treatment options?

In Vaginal Dryness: Treatment Options the Menopause Society elaborate on:

Vaginal Atrophy, Lubricants, Moisturizers, Oestrogen, More

  • “Nonhormone Remedies
    • Vaginal Lubricants…
    • Vaginal Moisturizers…
    • Regular Sexual Stimulation…
    • Expanding Your Views of Sexual Pleasure…
    • Vaginal Dilators…
    • Pelvic Floor Exercises…
  • Vaginal Hormone Therapy…
    • An effective and safe treatment, low-dose vaginal estrogen…
    • FDA-approved low-dose vaginal estrogen products…
    • Dehydroepiandrosterone (DHEA; Prasterone)…
    • Low-dose vaginal estrogen or DHEA may be options for…”.

Different Differences

Can different Countries have different brands for the treatment of vaginal atrophy?

Yes, so talk to your health care provider about your Country’s brands of vaginal lubricants, vaginal moisturizes, vaginal estrogen, systemic hormone therapies and more, that may be suitable for your vaginal symptoms.

Vaginal Lubricants

What are some vaginal lubricants?

In Vaginal Atrophy: Diagnosis & Treatment – Treatment the (United States) Mayo Clinic include:

  • Water-based lubricants. These lubricants (Astroglide, K-Y Jelly, Sliquid, others) are applied just before sexual activity and can reduce discomfort during intercourse. Choose products that don’t contain glycerin or warming properties because women who are sensitive to these substances may experience irritation. Avoid petroleum jelly or other petroleum-based products for lubrication if you’re also using condoms, because petroleum can break down latex condoms on contact”.

In Vulvovaginal Atrophy the European Menopause and Andropause Society (EMAS) note:

“Non-Hormonal Options Include

Vaginal Lubricants

  • May be water, silicone, hyaluronic acid or oil based
  • Are usually used prior to intercourse
  • Provide temporary relief of symptoms
  • Can be used alone or with systemic or topical menopausal hormone therapy”.

Vaginal Moisturizers

What are some vaginal moisturizers?

In Vaginal Atrophy: Diagnosis & Treatment – Treatment the Mayo Clinic explain:

  • Vaginal moisturizers. Try a vaginal moisturizer (K-Y Liquibeads, Replens, Sliquid, others) to restore some moisture to your vaginal area. You may have to apply the moisturizer every few days. The effects of a moisturizer generally last a bit longer than those of a lubricant”.

In Vulvovaginal Atrophy the EMAS note:

“Non-Hormonal Options Include

Vaginal Moisturizers

  • May contain a bioadhesive polycarbophil-based polymer
  • Are usually used on a regular basis, typically two or three times per week
  • Can be effective for mild symptoms
  • May cause local irritation
  • Can be used alone or with systemic or topical menopausal hormone therapy”.

Vaginal Oestrogen

What are some forms of vaginal oestrogen?

In Vaginal Atrophy: Diagnosis & Treatment – Treatment: Topical Estrogen the Mayo Clinic include:

“Vaginal estrogen therapy comes in a number of forms. Because they all seem to work equally well, you and your doctor can decide which one is best for you.

  • Vaginal estrogen cream (Estrace, Premarin). You insert this cream directly into your vagina with an applicator, usually at bedtime. Typically women use it daily for one to three weeks and then one to three times a week thereafter, but your doctor will let you know how much cream to use and how often to insert it
  • Vaginal estrogen suppositories (Imvexxy). These low-dose estrogen suppositories are inserted about 2 inches into the vaginal canal daily for weeks. Then, the suppositories only need to be inserted twice a week
  • Vaginal estrogen ring (Estring, Femring). You or your doctor inserts a soft, flexible ring into the upper part of the vagina. The ring releases a consistent dose of estrogen while in place and needs to be replaced about every three months. Many women like the convenience this offers. A different, higher dose ring is considered a systemic rather than topical treatment
  • Vaginal estrogen tablet (Vagifem). You use a disposable applicator to place a vaginal estrogen tablet in your vagina. Your doctor will let you know how often to insert the tablet. You might, for instance, use it daily for the first two weeks and then twice a week thereafter”.

Ospemifene

What is Ospemifene (Osphena)?

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 Mayo Clinic explain:

  • Ospemifene (Osphena). Taken by mouth, this selective estrogen receptor modulator (SERM) medicine treats painful intercourse linked to the thinning of vaginal tissue. This medicine isn’t for people who have had breast cancer or who are at high risk of breast cancer”.

Dehydroepiandrosterone (DHEA)

What is Dehydroepiandrosterone (DHEA)?

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 Mayo Clinic include:

  • Dehydroepiandrosterone (DHEA). This suppository is put into the vagina nightly. It eases painful intercourse after menopause”.

Systemic Hormone Therapy

When may systemic hormone therapy be suggested for vaginal atrophy?

In Vaginal Atrophy: Diagnosis & Treatment – Treatment the Mayo Clinic explain:

“If vaginal dryness is associated with other symptoms of menopause, such as moderate or severe hot flashes, your doctor may suggest estrogen pills, patches or gel, or a higher dose estrogen ring. Estrogen taken by mouth enters your entire system. Ask your doctor to explain the risks versus the benefits of oral estrogen, and whether or not you would also need to take another hormone called progestin along with estrogen”.

Alternative Medicine

Is alternative medicine recommended to treat vaginal atrophy?

In Vaginal Atrophy: Diagnosis & Treatment – Treatment the Mayo Clinic note:

“Some alternative medicines are used to treat vaginal dryness and irritation associated with menopause, but few approaches are backed by sufficient evidence from clinical trials. Interest in complementary and alternative medicine is growing, and researchers are working to determine the benefits and risks of various alternative treatments for genitourinary syndrome of menopause”.

Sexual Activity

May regular sexual activity help vaginal atrophy?

In Vaginal Atrophy: What You Can Do the JH explain:

“Regular sexual activity (including masturbation) – to improve blood flow to your vagina, which can keep vaginal tissues elastic and flexible. Sexually active women report fewer symptoms of vaginal atrophy compared to women who don’t have regular sex”.

Oils

Can vegetable oil, olive oil or sweet almond oil, be good-quality lubricants for intercourse?

In How Do I Deal With Vaginal Atrophy? — Ask Dr Jean the author include:

  • 2. For intercourse, use a good-quality lubricant. Natural lubricants include oils such as olive oil or sweet almond oil; however, if using condoms, note that these oils can cause them to break or tear”.

Flaxseed

Can flaxseed help with vaginal atrophy?

In Vaginal Atrophy: What You Can Do the JH explain:

  • “Flaxseed – some research suggests it may help with vaginal dryness. Grind the flaxseed and add two tablespoons to your cereal, salad or smoothies each day”.

Vaginal Laser Treatments

Are vaginal laser treatments safe and effective for the treatment of vaginal atrophy?

In Vaginal Atrophy: Management and Treatment – What Are Nonhormonal Treatments for Vaginal Atrophy (GSM)? Laser Treatments the (United States) Cleveland Clinic note:

“Noninvasive and nonsurgical CO2 laser treatments help regenerate vaginal tissue and improve its strength and elasticity after laser treatments. These devices aren’t yet approved by the Food and Drug Administration for vaginal atrophy because there’s limited long-term research on their use”.

Health Care Provider

What if I think I have vaginal atrophy?

In Vaginal Atrophy: Can Vaginal Atrophy Be Reversed? the JH explain:

Vaginal Atrophy, Lubricants, Moisturizers, Oestrogen, More “You cannot reverse vaginal atrophy, but you can stop it from getting worse by seeking a diagnosis and starting treatment early. Research suggests that MHT eliminates vaginal atrophy symptoms in 75% of cases, while vaginal oestrogen therapy is effective in 80% to 90% of cases. Without treatment, vaginal atrophy may get worse over time”.

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Last Updated: 29 August 2024 – Last Revised: 29 August 2024

Hormone Therapy Update August 2024 showcases some recent evidence-based information by Menopause Societies and International Sources.

Menopause Symptoms

How common are some menopause symptoms?

In Management of Menopausal Symptoms: A Review – Abstract: Importance, published 07 February 2024, the authors note:

Hormone Therapy Update May 2023“Menopause, due to loss of ovarian follicular activity without another pathological or physiological cause, typically occurs between the ages of 45 years and 56 years. During the menopausal transition, approximately 50% to 75% of women have hot flashes, night sweats, or both (vasomotor symptoms) and more than 50% have genitourinary symptoms (genitourinary syndrome of menopause [GSM])”.

Hormone Therapy

What is hormone therapy (HT)?

Depending on the Source the definition of HT may vary. In Menopause Management: Menopausal Hormone Therapy (MHT) – What Is MHT? the (Australian) Jean Hailes for Women’s Health’s definition is:

“Menopausal hormone therapy (MHT), formerly known as hormone replacement therapy (HRT), helps manage menopausal symptoms when they interfere with your life. Menopausal symptoms are caused by lowering levels of oestrogen hormones. MHT is the medical replacement of female hormones oestrogen and progesterone, and sometimes testosterone”.

The 2023 Practitioner’s Toolkit for Managing Menopause

Do the most robust menopause Clinical Practice Guidelines (CPGs) support MHT as the most effective treatment to alleviate VMS [Vasomotor Symptoms]?

In The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Considerations for All Women At Menopause: Menopausal Hormone Therapy, published online 30 October 2023, the authors explain:

“The most robust menopause Clinical Practice Guidelines (CPGs) support MHT as the most effective treatment to alleviate VMS”.

HT Benefits vs Risks

For healthy women, do the benefits of HT generally outweigh the risks?

On page one in Deciding About Hormone Therapy Use: Potential Risks the North American Menopause Society elaborate on:

“As with all medications, HT is associated with some potential risks. For healthy women with bothersome hot flashes aged younger than 60 years or within 10 years of menopause, the benefits of HT generally outweigh the risks”.

Health Care Provider

What if I would like to take HT?

In Menopause Management: Menopausal Hormone Therapy (MHT) – How Long Do Your Need To Take MHT? the JH explain:

“It can take around six months to find the right MHT. Once you’ve found an MHT that works for you, it’s important to review it with your doctor each year.

If you have premature menopause, your doctor will prescribe a higher dose of MHT until the age of expected menopause (around 50–52 years)”.

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Last Updated: 22 August 2024 – Last Revised: 22 August 2024

Hormone Therapy Update August 2023 showcases some recent evidence-based information by Menopause Societies and International Sources.

Menopause Symptoms

How common are some menopause symptoms?

In Management of Menopausal Symptoms: A Review – Abstract: Importance the authors note:

Hormone Therapy Update May 2023“Menopause, due to loss of ovarian follicular activity without another pathological or physiological cause, typically occurs between the ages of 45 years and 56 years. During the menopausal transition, approximately 50% to 75% of women have hot flashes, night sweats, or both (vasomotor symptoms) and more than 50% have genitourinary symptoms (genitourinary syndrome of menopause [GSM])”.

Hormone Therapy

What is hormone therapy (HT)?

Depending on the Source the definition of HT may vary. In Menopause Management: Menopausal Hormone Therapy (MHT) – What Is MHT? the (Australian) Jean Hailes for Women’s Health’s definition is:

“Menopausal hormone therapy (MHT), formerly known as hormone replacement therapy (HRT), helps manage menopausal symptoms when they interfere with your life. Menopausal symptoms are caused by lowering levels of oestrogen hormones. MHT is the medical replacement of female hormones oestrogen and progesterone, and sometimes testosterone”.

HT Benefits vs Risks

For healthy women, do the benefits of HT generally outweigh the risks?

On page one in Deciding About Hormone Therapy Use: Potential Risks the North American Menopause Society elaborate on:

“As with all medications, HT is associated with some potential risks. For healthy women with bothersome hot flashes aged younger than 60 years or within 10 years of menopause, the benefits of HT generally outweigh the risks”.

Health Care Provider

What if I would like some help to decide about taking HT?

If you would like some help to decide about taking HT it may be in your best interest to choose to discuss this with you health care provider.

On page two 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 one of the recommendations is:

  • “The decision whether to take HRT, the dose and duration of its use should be made on an individualised basis after discussing the benefits and risks with each patient. This should be considered in the context of the overall benefits obtained from using HRT including symptom control and improving quality of life as well as considering the bone and cardiovascular benefits associated with HRT use”.

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Last Updated: 07 August 2023 – Last Revised: 07 August 2023

“‘Early menopause’ is when the final menstrual period occurs between 40 and 45 years”. Some women share their stories about how early menopause affected them.

Early Menopause and Premature Menopause

Is early menopause the same as premature menopause?Early Menopause StoriesEarly Menopause Stories

In Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Early and Premature Menopause the (Scottish) NHS Inform explain:

“Menopause before the age of 45 is called early menopause. Menopause before the age of 40 is called premature menopause”.

Support After Early Menopause Your Stories

What is the (Australian) Jean Hailes for Women’s Health (JH) ‘Your Stories’?

In Support After Early Menopause Your Stories the (Australian) JH elaborate on:

“‘Your Stories’ is a place for women to share their health stories with us, to help support and encourage other women to make their health a priority too. Here is Natalie’s story.

Natalie, Melbourne, Victoria

Only hours after she was told she would have to undergo a hysterectomy and forego all hope of ever getting pregnant, Natalie headed off to her friend’s baby shower.

She and her husband had been trying for 18 months to have a baby. The endometriosis that Natalie had been trying to manage since her teens derailed their dream and the subsequent hysterectomy sent her into early menopause in her early 40s…”.

Early Menopause: Women’s Experiences

What is Early Menopause: Women’s Experiences?

In Early Menopause: Women’s Experiences – Overview, Healthtalk Australia elaborate on:

Early Menopause: Experiences and Perspectives of Women and Health Practitioners“On this unique site you can read, watch and listen to stories of 30 women aged between 28 and 51 years, from diverse socio-cultural backgrounds living in Victoria, Australia, who have shared what it is like to experience early menopause (EM).

Women talked about being diagnosed with spontaneous early menopause, premature ovarian insufficiency (POI), medically-induced early menopause, or menopausal symptoms as a result of cancer and/or other medical treatments”.

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Health Care Provider

What if I think I have early menopause?

If you think you have early menopause, it may be in your best interest to choose to talk to your health care provider about this. Together you can discuss your options and if required, agree on who may be the most appropriate health care provider to help you.

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Last Updated: 18 August 2024 – Last Revised: 18 August 2024

Menopause Questions To Ask emphasises how important it is for us to have our list of questions ready to ask a health care provider with an active interest in menopause.

Questions To Ask Your GP About Menopause

What is Questions To Ask Your GP About Menopause?

In Questions To Ask Your GP About Menopause the (Australian) Jean Hailes for Women’s Health (JH) Dr Elizabeth Farrell (pictured below right), elaborates on:

Menopause Questions To Ask“The reality is that when it comes to menopause there are big knowledge gaps among health professionals and the general public, says Dr Elizabeth Farrell, gynaecologist and Medical Director of Jean Hailes.

So what should you do? Here both doctors share some of the questions that women should be asking their GP about menopause, plus the answers and reasoning behind them”.

Who is a GP?

Depending on the Source and/or Depending on the Country, a GP may be a registered general practitioner, a medical practitioner, a medical doctor or a doctor.

When seeking advice about menopause, what sort of GP should a person try to find?

In Questions To Ask Your GP About Menopause: Do You Specialise In Menopause Care? the JH clinician GP Fiona Jane explains:

“Dr Jane (pictured above left): Seeking advice about menopause is one thing, but getting good, evidence-based, current information and management are another. Try to find a GP who takes an active interest in women’s health, is across the latest research and has time to talk. If your doctor is not confident in this area, ask for a referral to one who is”.

Questions for Your Health Care Provider

What is the (United States) Endocrine Society’s, Questions for Your Health Care Provider?

The Endocrine Society’s, Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider is a conversation starter of “some typical questions women ask their health care providers about menopause”:

Menopause Questions To Ask

Healthcare Provider

What if I would like menopause advice?

On page three 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 10 June 2022, the Conclusion includes:

“Women experience the menopause in different ways. Whilst some women experience minimal or no symptoms going through the menopause, many women experience menopausal symptoms that can significantly impact their quality of life. There should be an individualised approach in assessing women going through the menopause, with particular reference to lifestyle advice, diet modification as well as discussing the role of interventions including HRT. Women should be aware that help and support is available to them and should consult their GP for advice”.

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Topic Last Updated: 02 August 2024 – Topic Last Reviewed: 02 August 2024