What you describe is a natural result
of the loss of natural estrogen through menopause. There are a number of localized estrogen
options, including Estrace and Premarin creams, Vagifem tablets inserted in the vagina, and Estring, which is a ring also placed in the vagina. The therapeutic dose of Estrace is 1 gram applied to the vagina
and vulva two times a week; using less than that will be, as we doctors say, "subtherapeutic," which means it won't have sufficient effect! While the creams are effective when used as prescribed, many of my patients prefer and get more consistent doses from the ring or tablets. You mention a family history of breast cancer. None of these options is "systemic
," which means that they can be used by women with breast cancer risk factors--even by some breast cancer patients. There's a new option, too, that's non-estrogen: Osphena
is an oral daily medication that showed "statistically significant improvement" in vaginal and vulvar pain. Moisturizers
can also help to increase comfort while a full treatment plan is taking effect. It takes attention and consistency to regain comfort after being sexually inactive, but I'm sure you'll find it's worth the effort!
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