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 people after menopause. Vaginal dryness is the main symptom of what’s called genitourinary syndrome of menopause. The syndrome used to be called atrophic vaginitis or vaginal atrophy”.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 (United Kingdom) 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) (now the Menopause Society) 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:

  • “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 the context above, 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. ACOG Explains: Managing Menopause Symptoms [American College of Obstetricians and Gynecologists]
  2. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  3. BMS & WHC’s 2020 Recommendations on Hormone Replacement Therapy In Menopausal Women
  4. BMS TV: Bioidentical Hormones
  5. BMS TV: Hormone Replacement Therapy (HRT)
  6. BMS TV: Testosterone Explained
  7. BMS TV: Urogenital Atrophy
  8. Bioidentical Hormones: Are They Safer?
  9. Caredownthere
  10. Consumer Video and Podcast Series: 2023 Consumer Videos and Podcasts – Hormone Therapy: Understanding the Risks and Benefits
  11. Consumer Video and Podcast Series: 2023 Consumer Videos and Podcasts – Lifestyle Modification and Prevention of Breast Cancer
  12. Consumer Video and Podcast Series: 2024 Consumer Videos and Podcasts – Preparing for Your Menopause Health Care Visit
  13. Deciding About Hormone Therapy
  14. Deciding About Hormone Therapy Use
  15. Easier Access To Locally Applied HRT To Treat Postmenopausal Vaginal Symptoms In Landmark MHRA Reclassification [British Menopause Society]
  16. Easier Access To Locally-Applied HRT To Treat Postmenopausal Vaginal Symptoms In Landmark MHRA Reclassification [Medicines & Healthcare Products Regulatory Agency, GOV.UK]
  17. Endometrial Safety of Low-Dose Vaginal Estrogens
  18. Endometrial Safety of Low-Dose Vaginal Estrogens [Video]
  19. Estradiol Vaginal Cream
  20. Estradiol (Vaginal Route)
  21. Estradiol (Vaginal Route): Before Using
  22. Estradiol (Vaginal Route): Brand Name US
  23. Estradiol (Vaginal Route): Precautions
  24. Estradiol (Vaginal Route): Proper Use
  25. Estradiol (Vaginal Route): Side Effects
  26. Experiencing Vaginal Dryness? Here’s What You Need To Know
  27. FAQs: Vulvovaginal Health
  28. Find A Menopause Practitioner [United States and Other]
  29. Find An AMS Member [Australasian Menopause Society i.e. Australia and New Zealand]
  30. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  31. Genitourinary Syndrome of Menopause
  32. HRT
  33. HRT Questions Answered
  34. HRT – Types, Doses and Regimens
  35. HRT: Benefits and Risks
  36. Hormone Replacement Therapy (HRT): Vaginal Oestrogen
  37. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – About Vaginal Oestrogen
  38. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – Common Questions About Vaginal Oestrogen
  39. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – How and When To Use Vaginal Oestrogen
  40. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – Side Effects of Vaginal Estrogen
  41. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – Using Vaginal Oestrogen With Other Medicines and Herbal Supplements
  42. Hormone Replacement Therapy (HRT): Vaginal Oestrogen – Who Can and Cannot Use Vaginal Oestrogen
  43. Hormone Therapy: Is It Right for You?
  44. How To Talk To Your Doctor About Painful Sex
    Hormone Therapy and Vaginal Dryness
  45. International Society for the Study of Women’s Sexual Health: Find A Provider
  46. 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
  47. 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] [Other Languages and Formats]
  48. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Signs and Symptoms of Menopause [+ Video: Talking Menopause With Your GP] [Other Languages and Formats]
  49. 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] [Other Languages and Formats]
  50. Let’s Talk About Perimenopause
  51. Looking After Yourself After Menopause: Sex and Relationships
  52. Lubricant Alternatives: What To Use and What To Avoid
  53. Managing Your Symptoms: Managing Bladder, Vaginal and Vulval Problems
  54. Mayo Clinic Q and A: Treatment for Vaginal Dryness for Menopausal Women
  55. Menopause
  56. Menopause
  57. Menopause
  58. Menopause Map: Downloadable Resources – My Personal Path Print Tools – Questions for Your Health Care Provider
  59. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  60. Menopause Patient Information [Videos] 4. The Different Types of HRT
  61. Menopause Preparedness Toolkit Video Series: Common Conditions Associated With Menopause and Midlife
  62. Menopause Ruining Your Sex Life?
  63. Menopause Symptoms: Mayo Clinic Expert Outlines Hormone and Nonhormonal Therapies
  64. Menopause Treatments: What Works, What Doesn’t – Treatments for Vaginal Dryness
  65. Menopause: Things You Can Do
  66. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  67. Mymenoplan.org [My Menoplan, United States]
  68. Navigating Menopause Together: How Partners Can Help
  69. Navigating Menopause: Expert Insights and Solutions | Dr Susan Davis | The Proof Podcast EP 245
  70. Perimenopause and Menopause Checklist: Translated Checklists
  71. Perimenopause and Menopause Symptom Checklist
  72. Position Statement for Management of Genitourinary Syndrome of the Menopause (GSM)
  73. Prasterone for Vulvar and Vaginal Atrophy In Postmenopausal Women
  74. Prosayla Supported By ISSWSH [International Society for the Study of Women’s Sexual Health]
  75. Public Assessment Report – Prescription Only Medicine To Pharmacy Reclassification – Gina 10 Microgram Vaginal Tablets
  76. Risks and Benefits of MHT
  77. Shedding Light on the Menopause Experience and Demystifying Treatment
  78. The Impact of the Menopause
  79. The Menopause Society Statement on Misinformation Surrounding Hormone Therapy
    Hormone Therapy and Vaginal Dryness
  80. The North American Menopause Society Releases Its 2022 Hormone Therapy Position Statement
  81. The Truth About Menopause Supplements | Dr Sarah Berry
  82. Tips To Help Manage Menopause Symptoms
  83. Topical Estrogens and Non-Hormonal Preparations for Postmenopausal Vulvovaginal Atrophy: An EMAS Clinical Guide
  84. Topical Vaginal Oestrogen for Breast Cancer Patients
  85. Urogenital Problems
  86. Vaginal Atrophy
  87. Vaginal Dryness
  88. Vaginal Dryness
  89. Vaginal Dryness
  90. 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?
  91. Vaginal Dryness Alternative Treatments
  92. Vaginal Laser Therapy for GSM/VVA: Where We Stand Now – A Review By the EUGA Working Group on Laser
  93. Videos and Podcasts: Videos – Vulvovaginal Atrophy
  94. Vulval Irritation
  95. Vulvovaginal Atrophy
  96. Webinars: Previous – Genitourinary Syndrome of Menopause
  97. Why Didn’t Anyone Tell Me This? Episode 3: Dr Annice Mukherjee: Your Essential Menopause Toolkit
  98. Wild Yam
  99. World Menopause Day 2024: Leaflet for Women – Menopause and Menopause Hormone Therapy [Multiply Languages]
  100. Hormone Therapy and Vaginal DrynessWorld Menopause Day 2024: Poster for Women – The 5 Ws of Menopause Hormone Therapy (MHT)

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Deciding About Hormone Therapy Use. 2022:1. Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 06 April 2025
  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? 14 May 2024. Mayo Clinic https://www.mayoclinic.org/vaginal-dryness-after-menopause/expert-answers/faq-20115086 Accessed: 06 April 2025
  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: 06 April 2025
  4. Deciding About Hormone Therapy Use. 2022:1. Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 06 April 2025
  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: 06 April 2025
  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: 06 April 2025
  7. Vaginal Dryness: Notes. 2022:2. Menopause Society https://menopause.org/wp-content/uploads/for-women/mn-vaginal-dryness_4e454569-8d3c-4346-a00b-515f46b378c9.pdf Accessed: 06 April 2025
  8. Vaginal Dryness: Note. 2022: 2. Menopause Society https://menopause.org/wp-content/uploads/for-women/mn-vaginal-dryness_4e454569-8d3c-4346-a00b-515f46b378c9.pdf Accessed: 06 April 2025
Topic Last Updated: 06 April 2025 – Topic Last Reviewed: 06 April 2025

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