Estrogen Where It’s Needed

Okay, so you’ve tried everything. You regularly use a good, natural moisturizer, plus a lubricant during sex. No soaps, sprays, scents, dyes, or synthetic underwear ever touch your bottom. You’re the queen of vaginal hygiene. And still you’re troubled by dry, itching, or inflamed genitals and painful penetration. What now? Talk to your doctor about using a localized estrogen product for your vagina. These medicines deliver low dosages of estrogen right where it’s needed: the vagina and vulva. Not only is localized estrogen medication very effective at relieving the discomfort of vaginal inflammation or atrophy, but it also restores natural vaginal lubrication and elasticity. In fact, while it won’t relieve other menopausal symptoms—like hot flashes—low-dosage vaginal estrogen is sometimes more effective in relieving menopausal genital problems than systemic hormone replacement therapies (HRT). Moreover, the dosages are so low, the side effects and complications so negligible, it is often used by breast cancer survivors. Vaginal estrogen comes in several forms: a cream (used twice a week), or slow-release tablets (used twice a week), or a ring (which needs to be replaced every three months). Don’t, however, confuse the Estring vaginal ring with Femring, which is the high-dosage HRT in a vaginal ring form. (Confusing? It can be.) Your doctor will tailor the amount and frequency of application for the maximum effect at the lowest possible dose. It may also take several weeks for treatment to become fully effective. A few precautions:
  • Avoid applying your estrogen cream right before intercourse, since your partner can absorb it through his penis. Estrogen rings and tablets are meant to stay in place and don’t have this effect.
  • Continue to use non-hormonal lubricants and moisturizers if necessary.
  • Have regular vaginal intercourse to augment natural lubrication and a healthy vagina.
While localized estrogen may not be the first line of defense against the unpleasant genital changes related to menopause, it’s an important option when simpler methods (like vaginal lubricants or moisturizers) fail.

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