Hormone Therapy and Vaginal Estrogen

“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”.1

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

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

  • Hormone Replacement Therapy (HRT)
  • Hormone Therapy (HT)
  • Local Low-Dose Estrogen Therapy
  • Menopausal Hormone Therapy (MHT)
  • Vaginal Estrogen/Oestrogen

Statements

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

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”.2

NICE Guidelines

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

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”.3

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 directly to the vagina?

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

  • “Oestrogen can be applied directly to the vagina in the form of a cream, tablet or pessary”.4

On page two in Vaginal Dryness: Vaginal Estrogen Therapy the North American Menopause Society (NAMS) elaborate on:

Hormone Therapy and Vaginal Estrogen

  • “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”.5

Vaginal Symptoms

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

On page two in Vaginal Dryness the NAMS note:

“Note: Vaginal symptoms not related to menopause include yeast infections, allergic reactions, and certain skin conditions, so consult your health care provider if symptoms do not improve with treatment”.6

Health Care Provider

What if I would like to use vaginal estrogen?

If you would like to use vaginal estrogen, 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”.7

In Menopause FAQs: Hormone Therapy – Q. What is hormone therapy? 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”.8

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 Estrogen?

In Health Topics A-you may find:

Health Topics A-Z

Links

Where may I find Links related to Hormone Therapy and Vaginal Estrogen?

Your Country may have Links similar to:

Links

This Links List to third party websites is neither comprehensive nor exhaustive. Inclusion on this Links List does not imply endorsement or recommendation. Non-inclusion on this Links List does not imply non-endorsement or non-recommendation. Third party websites are not under the control of Meno Martha International Menopause Directory. Third party websites may contain explicit medical images and/or sexual references. Please read Meno Martha International Menopause Directory’s Links Policy before proceeding to a Link. Please contact Webmaster if you experience a problem with a Link.

  1. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT)
  2. BMS & WHC’s 2020 Recommendations on Hormone Replacement Therapy In Menopausal Women
  3. Bioidentical Hormone Therapy
  4. Bioidentical Hormones Explained – A British Menopause Society Video
  5. Bioidentical Hormones: Are They Safer?
  6. By the Way Doctor: Is Vaginal Estrogen Safe?
  7. Caredownthere
  8. Combined Menopausal Hormone Therapy (MHT)
  9. Complementary Medicine Options for Menopausal Symptoms
  10. Complementary and Alternative Therapies Explained – A British Menopause Society Video
  11. Consumer Health: Treating Vaginal Dryness After Menopause
  12. Deciding About Hormone Therapy
  13. Deciding About Hormone Therapy Use
  14. Early Menopause: Experiences and Perspectives of Women and Health Practitioners – Women’s Profiles
  15. Early Treatment of Vulvovaginal Atrophy May Prevent Distressing Symptoms
  16. Essential Information: See Your Doctor If
  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. Experiencing Vaginal Dryness? Here’s What You Need To Know
  23. Fast Facts: HRT and Breast Cancer Risk
  24. HRT
  25. HRT and Alternatives
  26. HRT: Benefits and Risks
  27. Hormone Replacement Therapy (HRT) Explained – A British Menopause Society Video
  28. Hormone Replacement Therapy (HRT): Alternatives
  29. Hormone Therapy: Is It Right for You?
  30. How Do I Deal With Vaginal Atrophy? — Ask Dr Jean
  31. Information About Menopause [Videos]
  32. Intercourse Was Becoming Painful – Ask Dr Jean
  33. International Society for the Study of Vulvovaginal Disease: Resource Library – Non Members/Patients
  34. Mayo Clinic Q and A: Managing the Symptoms of Vaginal Atrophy
  35. Menopause
  36. Menopause
  37. Menopause
  38. Menopause
  39. Menopause FAQs: Hormone Therapy for Menopause Symptoms
  40. Menopause FAQs: Menopause Symptoms – Q. How Can I Counteract Vaginal Dryness During Menopause?
  41. Menopause Management: Managing Vaginal Problems
  42. Menopause Matters
  43. Menopause Symptoms and Relief
  44. Menopause Treatment
  45. Menopause and Sexuality
  46. Menopause – Is Menopausal Hormone Therapy (HRT) Safe? [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: Menopause – Hormone Treatments
  53. Menopause: Non-HRT and Lifestyle Options [Video Interview Stories]
  54. Menopause: Relationships, Sex and Contraception and the Menopause [Video Interview Stories]
  55. Menopause: Symptoms & Causes
  56. NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use
  57. National Center for Complementary and Integrative Health: Herbs At A Glance
  58. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  59. National Center for Complementary and Integrative Health: Menopausal Symptoms: In Depth
  60. Non-Hormonal Treatment Options for Menopausal Symptoms
  61. NonHormonal Treatments for Menopausal Symptoms
  62. Oestrogen Only Menopausal Hormone Therapy
  63. PRAC Confirms Four-Week Limit for Use of High-Strength Estradiol Creams [Pharmacovigilance Risk Assessment Committee]
  64. Pain During or After Sex
  65. Recent Review Confirms Safety of Low Dose Vaginal Estrogen: July 2019
  66. Resequedad Vaginal
  67. Revised Global Consensus Statement on Menopausal Hormone Therapy
  68. Risks and Benefits of MHT
  69. Safety of Vaginal Estrogens: A Recap of A Systematic Review [Video]
  70. Sex & Relationships: 5 Things To Know About Sex In Later Life [Video]
  71. Sex and Menopause: Treatment for Symptoms
  72. The 2020 Genitourinary Syndrome of Menopause Position Statement of The North American Menopause Society
  73. The Use of Vaginal Estrogen In Women With A History of Estrogen-Dependent Breast Cancer
  74. Topical Estrogens and Non-Hormonal Preparations for Postmenopausal Vulvovaginal Atrophy: An EMAS Clinical Guide
  75. Urogenital Atrophy Explained – A British Menopause Society Video
  76. Urogenital Problems
  77. Vaginal Atrophy
  78. Vaginal Dryness
  79. Vaginal Dryness
  80. 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?
  81. Vaginal Dryness Alternative Treatments
  82. Vaginal Dryness and the Menopause
  83. Vaginal Dryness: Treatment Options
  84. Vaginal Dryness: Treatment Options Summary
  85. Video Series-2019 – Treatment Options for Vaginal Dryness In Survivors of Breast Cancer and In Those With A High Risk of Breast Cancer
  86. Video Series-2021 – Common Issues Surrounding Sexuality and Menopause
  87. Video Series-2021 – Treatment Options for Vaginal Dryness and Urinary Issues
  88. Video Series-2021 – What Women Need To Know About Hormone Therapies
  89. Vulva and Vaginal Health: Getting the Right Advice
  90. Vulvovaginal Health
  91. Vulvovaginal Symptoms After Menopause
  92. Webinars: Other Webinars – VVA – The Silent Epidemic [Vulvovaginal Atrophy]
  93. What Is Menopausal Hormone Therapy (MHT) and Is It Safe?
  94. Wild Yam
  95. Will Menopause Affect My Sex Life? [+ Video]
  96. Women Can Breathe Sigh of Relief When Using Vaginal Estrogen To Treat Menopause Symptoms
  97. Women’s Wellness: Painful Sex After Menopause
  98. Women’s Wellness: Signs and Symptoms of Vaginal Health Problems
  99. 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. 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: 12 May 2021
  2. 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/wp-content/uploads/2020/08/global-consensus-hrt-2016-06.pdf Accessed: 12 May 2021
  3. 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: 12 May 2021
  4. Menopause Management: Managing Vaginal Problems – Dry Vagina Treatments: Vaginal Oestrogen. Last Updated: 20 April 2021 | Last Reviewed: 17 December 2017. Jean Hailes https://jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 12 May 2021
  5. 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: 12 May 2021
  6. Vaginal Dryness: Note. 2018: 2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 12 May 2021
  7. Vaginal Dryness: Treatment Options. 2018: 1. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 12 May 2021
  8. Menopause FAQs: Hormone Therapy – Q. What is hormone therapy? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-hormone-therapy-for-menopause-symptoms Accessed: 12 May 2021

Topic Last Updated: 12 May 2021 – Topic Last Reviewed: 12 May 2021
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