In a previous blog post – Sexual Changes during Perimenopause and Beyond – I reviewed some of the sexual changes that may occur with menopause. One of the most common sexual issue for postmenopausal women is vaginal atrophy (atrophic vaginitis), the thinning and inflammation of vaginal walls induced by declining estrogen. Vaginal atrophy can lead to vaginal dryness and painful sexual intercourse.
Although many women do not seek help for this condition, estrogen treatment has been proven effective in restoring vaginal health and improving symptoms.
Estrogen Options
There are a number of low dose hormone therapies available in a variety of forms such as vaginal tablets, rings and creams. These local therapies relieve dryness and painful intercourse by rebuilding the lining of the vagina and urethra. Compared with oral formulations, locally administered estrogen therapies have lower risks because they do not act systemically with minimal absorption throughout the body. Another option is now available with the recent FDA approval of a lower dose (10mcg) formulation of Vagifem (estradiol vaginal tablets, from Novo Nordisk) for the treatment of atrophic vaginitis due to menopause. Vagifem is already available as a 25mcg vaginal tablet but the new dose formulation makes it the lowest local estrogen dose available in the U.S., giving women another option for consideration.
