Q: How might diabetes affect my vaginal dryness treatment options?

There really are no special considerations specific to your diabetes. While I can't confidently diagnose the cause of your pain with intercourse, I can't think of a diagnosis or treatment option that would be eliminated because of your diabetes. If you or your physician are considering systemic estrogen/progesterone, cardiovascular disease risks are taken into consideration. On the other hand, if localized (vaginal) estrogen could be part of the solution, cardiovascular disease risks are really not pertinent: The estrogen isn't absorbed systemically to any significant extent. (Don't interpret this to mean diabetics shouldn't be on hormone therapy. May of our new studies suggest that starting hormone therapy at a younger age--closer to menopause--may actually be cardio-protective.) I'm so glad you're taking the initiative to investigate your health and your options!

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