Menopause & Vaginal Health: What Actually Works?
Vaginal dryness, sexual discomfort and urinary leakage are just some of the vaginal health issues that women can experience during the menopause transition. Jessica Bell, a certified menopause provider, explains why these symptoms occur and what can be done to ease them.
Transcript:
Jamie Forward:
So, Jessica, for women that are experiencing things like vaginal dryness, discomfort with sex, or urinary leakage, what are the most effective, evidence-based treatments that are available today?
Jessica Bell:
There really is vaginal hormones, and that is safe for everybody to use. We can say that with all confidence now. So, vaginal estrogen is applied very locally at the tissue level. It works at the level. I often do this, this is the vulva-vagina, so it works very locally at the tissue level here. So, we can start using vaginal estrogen.
Cream before we need to use it, before intimacy is painful, before urinary tract infections are occurring, before urgency, frequency, and light incontinence is happening to us. So, the first treatment is vaginal estrogen. I often prefer the cream. There are other formulations. There’s a ring that goes inside of the vaginal canal.
There are tablets, there are suppositories. The benefit of the cream, though, is that a person can apply that inside of the vaginal canal and all around on the outside. I kind of describe it like a thin face cream for the vulva, is the way that I explain it. So, I would say that is our evidence-based recommendation that we have. There are also other types of vaginal hormones. There’s a suppository that’s a DHEA suppository. So, there are options.
Vaginal moisturizers can be helpful, but that really treats the dryness, kind of. I don’t know, I like analogies and I’m not always great at them, but it almost seems like the vaginal hormones are like the water to keep you hydrated, but sometimes, you might need some lotion as well. The lotion is maybe that moisturizer, the vaginal moisturizer. So, moisturizers and lubricants can decrease symptoms of dryness, but they don’t really treat the underlying cause, which is hormone decline at the tissue level.
So, I kind of believe in vaginal hormones for everyone, and also a vaginal moisturizer is good lubricant. All of that are other tools in the toolbox as well for vaginal health or pelvic health.
