This is a common question among many age groups of women. The first thing to consider is “What is causing the vaginal dryness?” Sometimes, causes could be infectious, such as a yeast infection or hormonal causes from a lack of estrogen. For this particular instance, we will focus on treatment options for women who lack vaginal estrogen.
Women can have low vaginal estrogen tissue changes due to many causes, the most common being: natural low production of hormones, breastfeeding, birth control, and menopause. Symptoms can include painful intercourse, vaginal itching or discomfort, vaginal bleeding, and even urinary incontinence or urgency. Women can often be very shy and reluctant to ask for help, despite this being so common. But options are becoming more common and readily available!
First, there is Replens, an over the counter, hormone free vaginal moisturizer that you use vaginally about every 3 days. Other over the counter sources are mineral oil, coconut oil, Vaseline, etc, all of which can be soothing to the vaginal tissue. There are also several hormonal options. Of course, any estrogen containing hormone, whether pill, patch, topical, pellet or injectable, can help vaginal dryness as well as help other estrogen deficiency symptoms like hot flashes or night sweats.
However, some women only have vaginal dryness and want a treatment focused only on this issue.
A vaginal estrogen insert would potentially be better than systemic hormonal treatments. There are also estradiol creams such as Premarin and Estrace. Additionally, there are options of compounded topical estrogens can be found at local compounding pharmacies.
Other choices becoming more common are dissolvable estrogen pill inserts, Yuvafem, or estrogen suppository, Imvexxy. These pills and suppositories tend to be less “messy” than cream.
There are also a few new non-hormone options are available. One is Osphena, which is a daily pill that acts on estrogen receptors, but isn’t a hormone. Another option is Intrarosa, a steroid that is naturally produced in the adrenals that stimulates estrogen production in vaginal tissue. It is in a vaginal suppository form used nightly. Lastly, there are some new procedural treatments used for vaginal dryness, such as The O-shot and new CO2 laser treatments.
As you can see, there are a large variety of choices for the treatment of vaginal dryness. Each option needs to be customized to each patients’ needs and the route desired. The proper choice of therapy must also take individual factors into consideration. Come see one of our gynecologists to discuss if any of these options are right for you. You are certainly not alone and don’t need to suffer when so many choices are available.