Vaginal Estrogen Therapy (I put that WHERE?)

During menopause, your body begins to produce less estrogen, which can cause uncomfortable changes in your “lady parts.” You know what I’m talking about…vaginal and vulvar dryness, soreness, and itchiness, urgency and pain while peeing, and pain during sexual intercourse.

Many women can find relief over-the-counter with vaginal moisturizers and lubricants. Some however will need low-dose vaginal estrogen therapy to relieve their symptoms and restore vaginal health. Talk to your healthcare provider if you have tried non-prescription methods without success. If your healthcare professional feels low-dose estrogen therapy is right for you, they will prescribe it in one of 3 forms: Vaginal cream, vaginal ring, or vaginal tablet.

Vaginal Creams

These creams go by brand names such as Premarin, Estrace, and Neo-Estrone (in Canada). You place a small amount (as directed) in the vagina 2-3 times per week using a small plastic applicator. For easy insertion, lie on your back with your knees up or stand with one foot up on a chair, toilet seat, or the side of the bathtub. Insert the applicator into the vagina, push the plunger until it stops, and remove the applicator, leaving the cream behind. Clean the applicator after use by removing the plunger and washing both pieces in warm (not boiling) soapy water and drying them completely. Estrogen creams should NOT be applied before intercourse or used as a lubricant since the hormone can be absorbed through your partner’s skin.

Vaginal Ring

Estring is a flexible ring is placed inside the vagina and worn for 3 months before it is taken out and replaced. It should not be confused with Femring, which releases higher doses of estrogen to treat other symptoms such as hot flashes. To insert it, pinch the sides of the ring between two fingers and lie back with your knees up or stand with one foot up. Part the folds of skin around your vagina with one hand and insert the ring slowly to the upper third of your vagina, stopping if it becomes uncomfortable. To remove it, insert one finger and hook it into the ring, then draw it out. Dispose of the ring in the trash, NOT the toilet. The insert doesn’t have to be removed during intercourse.

Vaginal Tablet

The vaginal tablet, Vagifem, is inserted twice a week using an applicator (just like the cream) or finger.

If you miss a dose, take it as soon as you realize, unless it’s almost time for your next dose. Don’t double up on doses.

Low-dose vaginal estrogen therapy can be a lifesaver for women who are struggling with vaginal dryness and irrigation as their most troubling menopause symptom. If you’re having significant problems with other issues like hot flashes and night sweats, your healthcare provider may suggest higher-dose hormone replacement therapy to ease your symptoms.

References

  1. Vaginal and vulvar comfort: Lubricants, moisturizers and low-dose vaginal estrogen,” http://www.menopause.org/for-women/sexual-health-menopause-online/effective-treatments-for-sexual-problems/vaginal-and-vulvar-comfort-lubricants-moisturizers-and-low-dose-vaginal-estrogen. Accessed September 21, 2015.
  2. “Estrogen: Vaginal route.” http://www.mayoclinic.org/drugs-supplements/estrogen-vaginal-route/description/drg-20069459. Accessed September 21, 2015.

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