Vaginal estrogen for postmenopausal women has been in the UK news. Gina 10 microgram vaginal tablets are to become available, without a prescription, from local pharmacies.

Gina 10 Microgram Vaginal Tablets

In the United Kingdom (UK), what did the news about Gina 10 microgram vaginal tablets explain?

In the press release Easier Access To locally-Applied HRT To Treat Postmenopausal Vaginal Symptoms In Landmark MHRA Reclassification, published 20 July 2022, the (United Kingdom) Medicines and Healthcare Products Regulatory Agency elaborate on:

“For the first time ever in the UK, postmenopausal women will be able to access a low dose Hormone Replacement Therapy (HRT) product from their local pharmacies without prescription, the Medicines and Healthcare products Regulatory Agency (MHRA) announced today.

Gina 10 microgram vaginal tablets (containing estradiol) are used for the treatment of vaginal symptoms such as dryness, soreness, itching, burning and uncomfortable sex caused by oestrogen deficiency in postmenopausal women aged 50 years and above who have not had a period for at least 1 year. This product is locally-applied, meaning it is inserted into the vagina and not taken orally”.

Vaginal Atrophy

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“Around the time of menopause, women experience changes to the vagina and urinary (wee) system that is caused by decreased levels of the hormone oestrogen in the body. These changes are described as vaginal atrophy — also known as genitourinary syndrome of menopause (GSM). Vaginal atrophy affects around 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 North American Menopause Society (NAMS) 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 Estrogen Therapy…
    • An effective and safe treatment…
    • Government-approved low-dose vaginal estrogen products…
    • Standard doses of estrogen therapy…
  • Other Prescription Therapies…
    • Ospemifene …
    • Dehydroepiandrosterone (DHEA)”.

Different Differences

Can different Countries have different treatment brands for 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 symptoms of vaginal atrophy.

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: Non-Hormonal Options Include: Vaginal Lubricants the European Menopause and Andropause Society (EMAS) note:

  • “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 include:

  • 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: Non-Hormonal Options Include: Vaginal Moisturizers the EMAS note:

  • “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 is some 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”.

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 also note:

  • “If you’ve had breast cancer, talk with your doctor about the risks of vaginal estrogen therapy”.


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 include:

  • Ospemifene (Osphena), a selective estrogen receptor modulator (SERM) medication taken by mouth is used to treat painful intercourse associated with vaginal atrophy. This medication isn’t recommended for women 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), in the form of a nightly vaginal suppository is a treatment that may ease painful intercourse in menopausal women”.

Systemic Hormone Therapy

When may systemic hormone therapy be suggested for vaginal atrophy?

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

“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”.

Vaginal Laser Therapy

Is vaginal laser therapy an effective and safe treatment for vaginal atrophy?

In Non-Estrogen Treatments for Menopausal Symptoms: Treating Vaginal Symptoms the EMAS note:

“Laser Therapy (ablative and non-ablative) is a new approach, but large, long-term studies are required to explore its efficacy and safety.”

Sexual Activity

May regular sexual activity help prevent vaginal atrophy?

In Vaginal Atrophy: Prevention of Vaginal Atrophy the JH explain:

“Regular sexual activity (with or without a partner) may help prevent vaginal atrophy. Sexual activity improves blood flow to the vagina which helps keep vaginal tissues elastic and flexible. Sexually active women report fewer symptoms of vaginal atrophy compared to women who don’t have regular sex”.


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 explains:

  • 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”.

In Vaginal Atrophy: Management and Treatment – How Is Vaginal Atrophy (Atrophic Vaginitis) Treated? the (United States) Cleveland Clinic note:

“Vaseline is NOT recommended for use inside the vagina because it can lead to yeast infections. Though many women use olive or coconut oils as a moisturizer and lubricant, occasionally this may cause an allergic irritation in the vaginal area. Vitamin E and mineral oils should be avoided”.

Ground Linseed

Can adding freshly ground linseed to our diet help vaginal dryness?

In Vaginal Atrophy: Treatment for Vaginal Atrophy – Non-Hormonal Treatments the JH explain:

  • “Eating 2 tablespoons of freshly ground linseed (also known as flaxseed), a plant-based oestrogen or phytoestrogen, each day may also help with vaginal dryness. You can add this food to your cereal, in salads or smoothies”.


What else can I try to reduce vaginal atrophy?

In Vaginal Dryness: Symptoms, Causes and Remedies the author explains:

“Here are a few things you can try to reduce vaginal dryness:

  • Avoid bath soaps, lotions or gels that contain perfumes
  • Avoid all bubble baths, bath salts and scented oils
  • Do not use hot water while bathing or showering
  • Avoid all feminine hygiene sprays and perfumes
  • Do not use adult or baby wipes on the area
  • Avoid tight-fitting clothing and pantyhose. Wear white, 100% cotton underwear
  • Avoid all over-the-counter creams and ointments, except A&D Ointment. But do not use A&D Ointment if you have a wool allergy.”

Health Care Provider

What if I think I have vaginal atrophy?

In Vaginal Discomfort: Discomfort Not Directly Related To Menopause the NAMS elaborate on:

“Because vaginal discomfort can arise from so many different sources, persistent symptoms of dryness, irritation, burning, itchiness, or pain should be evaluated by a healthcare provider to determine their cause”.

In Vaginal Atrophy: When To See Your Doctor the JH note:

Vaginal Atrophy, Lubricants, Moisturizers, Oestrogen, More “Many women experience the symptoms of vaginal atrophy but don’t seek treatment because they feel embarrassed. Others think there is nothing that can be done and that they just have to ‘grin and bear it’. If you experience any of the signs or symptoms mentioned, make an appointment with your doctor because treatment can be very effective. If pain, irritation or other symptoms continue after treatment, please see your doctor to check for another cause”.

In Vulvovaginal Symptoms After Menopause the Australasian Menopause Society remind us:

  • “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 aging”.

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Last Updated: 02 August 2022 – Last Revised: 02 August 2022