Hormone Therapy and Vaginal Dryness

“Local low-dose estrogen therapy is preferred for women whose symptoms are limited to vaginal dryness or associated discomfort with intercourse or for…”.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

Statements

What is one of the points of consensus about menopausal hormone therapy (MHT) and vaginal dryness?

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT – endorsed by seven menopause-related organizations – published online 20 June 2016, is:

  • “MHT, including tibolone, is effective in the treatment of vulvovaginal atrophy (VVA), now also considered as a component of the genitourinary syndrome of menopause (GSM). Local low-dose estrogen therapy is preferred for women whose symptoms are limited to vaginal dryness or associated discomfort with intercourse or for the prevention of recurrent urinary tract infections”.3

NICE Guidelines

What do the (British) National Institute for Health and Care Excellence’s (NICE) guidelines note about HT and vaginal dryness?

In Menopause: Diagnosis and Management – Information for the Public: Managing Your Symptoms the NICE note about Vaginal Dryness:

“If you have vaginal dryness you should be offered vaginal oestrogen, which is put directly into the vagina as a pessary, cream or a vaginal ring. You can use vaginal oestrogen for as long as you need to, even if you are already using HRT. Moisturisers and lubricants can also help. If vaginal oestrogen doesn’t help to start with you may be offered a higher dose.

It’s rare for vaginal oestrogen to cause problems, but if you have any unexpected vaginal bleeding you should tell your GP. Your GP should explain that your symptoms may come back when you stop using it.

Vaginal oestrogen might be suitable for you if you can’t take HRT for medical reasons. Your GP should check this first with a healthcare professional specialising in menopause”.4

Who is a GP?

Dots and/or DotC (Depending on the Country) a GP may be a registered general practitioner, a medical practitioner, a medical doctor or a doctor.

Cream, Tablet, Pessary or Ring

How can estrogen be applied to the vagina?

In Menopause Management: Managing Vaginal Problems – Dry Vaginal Treatments: Vaginal Estrogen the (Australian) Jean Hailes for Women’s Health explain:

Hormone Therapy and Vaginal Dryness

  • “Oestrogen can be applied directly to the vagina in the form of a cream, tablet or pessary”.5

In Menopause FAQs: Hormone Therapy for Menopause Symptoms – Q. What is hormone therapy? the North American Menopause Society (NAMS) explain for genitourinary syndrome of menopause (GSM):

“Vaginal estrogen therapy for GSM after menopause is administered into the vagina and is effective for moisturizing and rebuilding tissue. Very little goes into blood circulation, so the risks are far lower”.6

Vaginal Estrogen

Are all vaginal symptoms at this time, related to menopause?

On page two in Vaginal Dryness: Vaginal Estrogen Therapy the NAMS elaborate on:

  • “Government-approved low-dose vaginal estrogen products are available by prescription as vaginal creams (used two or three nights/week), a vaginal estradiol tablet (used twice/week), and an estradiol vaginal ring (changed every 3 months). All are highly effective. You may wish to try several different forms and choose the one you prefer”.7

Vaginal Symptoms

Are all vaginal symptoms at this time, related to menopause?

On page two in Vaginal Dryness the NAMS explain:

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

Health Care Provider

What if I think I have vaginal dryness?

If you think you have vaginal dryness, it may be in your best interest to choose to talk to your health care provider about this.

On page one in Vaginal Dryness: Treatment Options the NAMS elaborate on:

“The good news is that effective treatment options, such as nonhormone remedies or different forms of low-dose estrogen applied directly to the vagina, are available. These can be combined for optimal symptom relief”.9

In Vulvovaginal Symptoms After Menopause the Australasian Menopause Society caution:

  • “Unlike some menopausal symptoms, such as hot flushes, which may disappear as time passes; genito-urinary problems often persist and may progress with time. Genito-urinary symptoms are associated both with menopause and with ageing”.10

The NAMS also note:

“You should discuss your individual risks and preferences with your healthcare team to determine whether hormone therapy or alternatives, including FDA-approved nonhormonal therapies, are right for you”.11

What is FDA?

FDA can be an abbreviation for the (United States) Food and Drug Administration.

Health Topics A-Z

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

In Health Topics A-Z you may find:

Health Topics A-Z

Links

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Links

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  1. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 6. Myth – Complementary Medicines and Therapies Are As Effective As MHT and Safer
  2. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 7. Myth – Compounded Bioidentical Hormone Therapy Is Safer Than Conventional MHT
  3. Bioidentical Custom Compounded Hormone Therapy
  4. Bioidentical Hormone Therapy
  5. Bioidentical Hormones Explained – A British Menopause Society Video
  6. By the Way Doctor: Is Vaginal Estrogen Safe?
  7. Caredownthere.com.au
  8. Combined Menopausal Hormone Therapy (MHT)
  9. Complementary Medicine Options for Menopausal Symptoms
  10. Deciding About Hormone Therapy
  11. Deciding About Hormone Therapy Use
  12. Decidir Sobre La Hormonoterapia
  13. Early Menopause: Experiences and Perspectives of Women and Health Practitioners – Women’s Profiles
  14. Early Treatment of Vulvovaginal Atrophy May Prevent Distressing Symptoms
  15. Essential Information: See Your Doctor If
  16. Estrogen (Vaginal Route): Before Using
  17. Estrogen (Vaginal Route): Description and Brand Names
  18. Estrogen (Vaginal Route): Precautions
  19. Estrogen (Vaginal Route): Proper Use
  20. Estrogen (Vaginal Route): Side Effects
  21. Everything You Wanted To Know About Painful Sex… But Were Too Embarrassed To Ask
  22. Fact Sheets and Downloads: Additional Downloadable Resources – Vaginal Estrogen Therapy
  23. For Women Factsheets
  24. HRT
  25. HRT and Alternatives
  26. Hormone Replacement Therapy (HRT)
  27. Hormone Replacement Therapy (HRT) Explained – A British Menopause Society Video
  28. Hormone Replacement Therapy (HRT): Alternatives
  29. Hormone Replacement Therapy (HRT): Types
  30. Index To Drug-Specific Information [United States]
  31. Information About Menopause [Multiply Languages] [Videos]
  32. Intercourse Was Becoming Painful – Ask Dr Jean
  33. International Society for the Study of Vulvovaginal Disease: Resource Library – Patients
  34. Managing Menopause: Don’t Let Symptoms of Menopause Reduce Your Quality of Life
  35. Menopause
  36. Menopause
  37. Menopause
  38. Menopause
  39. Menopause FAQs: Menopause Symptoms – Q. How can I counteract vaginal dryness during menopause?
  40. Menopause Management: Managing Vaginal Problems
  41. Menopause Symptoms and Relief
  42. Menopause – Complementary Therapies [Multiply Languages] [Video]
  43. Menopause – Is Menopausal Hormone Therapy (HRT) Safe? [Multiply Languages] [Video]
  44. Menopause – Non-Hormonal Treatment Options [Multiply Languages] [Video]
  45. Menopause – What Are the Symptoms? [Multiply Languages] [Video]
  46. Menopause – What Is Menopausal Hormone Therapy (HRT)? [Multiply Languages] [Video]
  47. Menopause – Will It Affect My Sex Life? [Multiply Languages] [Video]
  48. Menopause: Diagnosis & Treatment
  49. Menopause: Diagnosis and Management – Information for the Public: Questions To Ask About Menopause [NICE Guideline]
  50. Menopause: Hormone Replacement Therapy (HRT) [Video Interview Stories]
  51. Menopause: Libido, Vaginal Dryness and Urinary Problems and the Menopause [Video Interview Stories]
  52. Menopause: Medicines To Help You
  53. Menopause: Menopause – Hormone Treatments
  54. Menopause: Non-HRT and Lifestyle Options [Video Interview Stories]
  55. Menopause: Relationships, Sex and Contraception and the Menopause [Video Interview Stories]
  56. Menopause: Symptoms & Causes
  57. Mona Lisa Touch – Ask Dr Jean
  58. NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use
  59. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  60. National Center for Complementary and Integrative Health: Know the Science: How Medications and Supplements Can Interact
  61. National Center for Complementary and Integrative Health: Menopausal Symptoms In Depth
  62. National Center for Complementary and Integrative Health: Natural Doesn’t Necessarily Mean Safer, or Better
  63. New Study Reassures Women About the Safety of Vaginal Estrogen
  64. Non-Hormonal Treatment Options for Menopausal Symptoms
  65. NonHormonal Treatments for Menopausal Symptoms
  66. Oestrogen Only Menopausal Hormone Therapy
  67. Pain During or After Sex
  68. PRAC Confirms Four-Week Limit for Use of High-Strength Estradiol Creams [Pharmacovigilance Risk Assessment Committee]
  69. Patient Information Leaflet: Vaginal Atrophy – A Change With the Menopause
  70. Recent Review Confirms Safety of Low Dose Vaginal Estrogen: July 2019
  71. Resequedad Vaginal
  72. Sex and Menopause: Treatment for Symptoms
  73. Shrinking Sensation In Genital Area – Ask Dr Jean
  74. Urogenital Atrophy Explained – A British Menopause Society Video
  75. Urogenital Problems
  76. Vaginal Atrophy
  77. Vaginal Discomfort
  78. Vaginal Dryness
  79. Vaginal Dryness
  80. Vaginal Dryness
  81. Vaginal Dryness
  82. Vaginal Dryness After Menopause: How To Treat It?
  83. Vaginal Dryness Alternative Treatments
  84. Vaginal Dryness and the Menopause
  85. Vaginal Health After Breast Cancer: A Guide for Patients
  86. Video Series-2018 – Moisturizers, Lubricants, and Prasterone
  87. Video Series-2018 – Risks and Benefits of Long Term Hormone Therapy
  88. Video Series-2019 – Talking To Your Clinician About Sexual Health Concerns
  89. Video Series-2020 – How To Talk To Your Primary Care Clinician About Your Overall Health
  90. Vulva and Vaginal Health: Getting the Right Advice
  91. Vulvovaginal Health
  92. Vulvovaginal Symptoms After Menopause
  93. What Are the Signs and Symptoms of Menopause?
  94. What Is Menopausal Hormone Therapy (MHT) and Is It Safe?
  95. Wild Yam
  96. Will Menopause Affect My Sex Life? [+ Video]
  97. Women Can Breathe Sigh of Relief When Using Vaginal Estrogen To Treat Menopause Symptoms
  98. Women’s Wellness: Painful Sex After Menopause
  99. Women’s Wellness: Signs and Symptoms of Vaginal Health Problems
  100. Women’s Wellness: Vaginal Atrophy After Breast Cancer

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT. Climacteric, 2016;19:4:313 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 25 September 2020
  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? 11 July 2020. Mayo Clinic https://www.mayoclinic.org/vaginal-dryness-after-menopause/expert-answers/faq-20115086 Accessed: 25 September 2020
  3. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT. Climacteric, 2016;19:4:313 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 25 September 2020
  4. Menopause: Diagnosis and Management – Information for the Public: Managing Your Symptoms – Vaginal Dryness. Published Date: 12 November 2015. Last Updated: 05 December 2019. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/ng23/ifp/chapter/Managing-your-symptoms Accessed: 25 September 2020
  5. Menopause Management: Managing Vaginal Problems – Dry Vagina Treatments: Vaginal Oestrogen. Last Updated: 30 July 2020 | Last Reviewed: 17 December 2017. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 25 September 2020
  6. Menopause FAQs: Hormone Therapy for Menopause Symptoms – Q. What is hormone therapy? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-hormone-therapy-for-menopause-symptoms Accessed: 25 September 2020
  7. Vaginal Dryness: Vaginal Estrogen Therapy. 2018: 2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 25 September 2020
  8. Vaginal Dryness: Note. 2018: 2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 25 September 2020
  9. Vaginal Dryness: Treatment Options. 2018: 1. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 25 September 2020
  10. Vulvovaginal Symptoms After Menopause. Content Created September 2018. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/376-vulvovaginal-symptoms-after-menopause Accessed: 25 September 2020
  11. Menopause FAQs: Hormone Therapy for Menopause Symptoms – Q. What is hormone therapy? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-hormone-therapy-for-menopause-symptoms Accessed: 25 September 2020

Topic Last Updated: 25 September 2020 – Topic Last Reviewed: 25 September 2020
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