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. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  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. Caredownthere
  7. Combined Menopausal Hormone Therapy (MHT)
  8. Complementary Medicine Options for Menopausal Symptoms
  9. Complementary and Alternative Therapies Explained – A British Menopause Society Video
  10. Consumer Health: Treating Vaginal Dryness After Menopause
  11. Deciding About Hormone Therapy
  12. Deciding About Hormone Therapy Use
  13. EMAS Menopause Essentials
  14. EMAS Replay: Risk Assessment for MHT – When, To Whom, Which, and How Long? [Multiply Languages]
  15. Early Menopause: Experiences and Perspectives of Women and Health Practitioners – Women’s Profiles
  16. Early Treatment of Vulvovaginal Atrophy May Prevent Distressing Symptoms
  17. Essential Information: See Your Doctor If
  18. Estrogen (Vaginal Route): Before Using
  19. Estrogen (Vaginal Route): Description and Brand Names
  20. Estrogen (Vaginal Route): Precautions
  21. Estrogen (Vaginal Route): Proper Use
  22. Estrogen (Vaginal Route): Side Effects
  23. Experiencing Vaginal Dryness? Here’s What You Need To Know
  24. Fast Facts: HRT and Breast Cancer Risk
  25. HRT
  26. HRT and Alternatives
  27. HRT: Benefits and Risks
  28. HRT: Types, Doses and Regimens
  29. Hormone Replacement Therapy (HRT) Explained – A British Menopause Society Video
  30. Hormone Replacement Therapy (HRT): Alternatives
  31. Hormone Therapy: Is It Right for You?
  32. How Do I Deal With Vaginal Atrophy? — Ask Dr Jean
  33. Intercourse Was Becoming Painful – Ask Dr Jean
  34. International Society for the Study of Women’s Sexual Health: Find A Provider
  35. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Sexual Wellbeing and Intimacy During and After Menopause [+ Video: Menopause Is the End of Your Sex Life]
  36. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Signs and Symptoms [+ Video: Talking Menopause With Your GP]
  37. 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]
  38. Mayo Clinic Q and A: Managing the Symptoms of Vaginal Atrophy
  39. Menopause
  40. Menopause
  41. Menopause
  42. Menopause
  43. Menopause
  44. Menopause FAQs: Hormone Therapy for Menopause Symptoms
  45. Menopause FAQs: Menopause Symptoms – Q. How Can I Counteract Vaginal Dryness During Menopause?
  46. Menopause Management: Managing Vaginal Problems
  47. Menopause Map: Downloadable Resources – My Personal Path Print Tools – Questions for Your Health Care Provider
  48. Menopause Symptoms and Relief
  49. Menopause Treatment
  50. Menopause: Diagnosis & Treatment
  51. Menopause: Diagnosis and Management – Information for the Public: Questions To Ask About Menopause [NICE Guideline]
  52. Menopause: Is Menopausal Hormone Therapy (HRT) Safe? [Multiply Languages] [Video]
  53. Menopause: Menopause – Hormone Treatments
  54. Menopause: Symptoms & Causes
  55. NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use
  56. National Center for Complementary and Integrative Health: Herbs At A Glance
  57. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  58. National Center for Complementary and Integrative Health: Menopausal Symptoms: In Depth
  59. Natural Remedies To Help Manage Perimenopause Symptoms
  60. NonHormonal Treatments for Menopausal Symptoms
  61. Oestrogen Only Menopausal Hormone Therapy
  62. Pain During or After Sex
  63. Patty Brisben Foundation for Women’s Sexual Health: Guide To Sexual Health Providers
  64. Recent Review Confirms Safety of Low Dose Vaginal Estrogen: July 2019
  65. Revised Global Consensus Statement on Menopausal Hormone Therapy
  66. Risks and Benefits of MHT
  67. Safety of Vaginal Estrogens: A Recap of A Systematic Review [Video]
  68. Sex & Relationships: 5 Things To Know About Sex In Later Life [Video]
  69. Sex and Menopause: Treatment for Symptoms
  70. The 2020 Genitourinary Syndrome of Menopause Position Statement of The North American Menopause Society
  71. The Use of Vaginal Estrogen In Women With A History of Estrogen-Dependent Breast Cancer
  72. Topical Estrogens and Non-Hormonal Preparations for Postmenopausal Vulvovaginal Atrophy: An EMAS Clinical Guide
  73. Urogenital Atrophy Explained – A British Menopause Society Video
  74. Urogenital Problems
  75. Vaginal Atrophy
  76. Vaginal Dryness
  77. Vaginal Dryness
  78. 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?
  79. Vaginal Dryness Alternative Treatments
  80. Vaginal Dryness and the Menopause
  81. Vaginal Dryness: Treatment Options
  82. Video Series-2021: Common Issues Surrounding Sexuality and Menopause
  83. Video Series-2021: Female Urinary and Bladder Issues At Midlife
  84. Video Series-2021: How Menopause Symptoms Can Affect Your Quality of Life
  85. Video Series-2021: Treatment Options for Vaginal Dryness and Urinary Issues
  86. Video Series-2021: What Women Need to Know About Hormone Therapies
  87. Video Series-2022: Perimenopause, Signs, Symptoms, and Solutions
  88. Video Series-2022: Hormone Therapy: Understanding the Risks and Benefits
  89. Videos and Podcasts: Interviews and Podcasts – Interviews: Vulvovaginal Atrophy
  90. Vulva and Vaginal Health: Getting the Right Advice
  91. Vulvovaginal Health
  92. Vulvovaginal Symptoms After Menopause
  93. Webinars: Previous – The Early Menopausal Patient
  94. Webinars: Previous – VVA – The Silent Epidemic [Vulvovaginal Atrophy]
  95. What Is Menopausal Hormone Therapy (MHT) and Is It Safe?
  96. Wild Yam
  97. Will Menopause Affect My Sex Life? [+ Video]
  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. 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: 01 April 2022
  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: 01 April 2022
  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: 01 April 2022
  4. Menopause Management: Managing Vaginal Problems – Dry Vagina Treatments: Vaginal Oestrogen. Last Updated: 13 July 2021 | Last Reviewed: 17 December 2017. Jean Hailes https://jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 01 April 2022
  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: 01 April 2022
  6. Vaginal Dryness: Note. 2018: 2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/mn-vaginal-dryness.pdf Accessed: 01 April 2022
  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: 01 April 2022
  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: 01 April 2022

Topic Last Updated: 24 May 2022 – Topic Last Reviewed: 01 April 2022
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