In the past only topical estrogen products were offered. Mow even non-medical CO2 fractional virtually painless office laser procedures have been gaining in popularity. They require 3 treatments 6 weeks apart, with almost 50% improvement after the first treatment. Over 90% of women will have almost complete relief of painful sex with this non-invasive therapy. MonaLisaTouch.
Generally gynos have recommended nonhormonal moisturizers if you have mild symptoms, and estrogen therapy as the treatment of choice for this condition, and now we have the new painful sex treatment ospemifene. Ospemifene is a selective estrogen receptor modulator that makes vaginal tissue thicker and less fragile, resulting in a reduction in the amount of pain women experience with sexual intercourse. Although gynos estimate that virtually all women remaining sexually active into their post menopausal years will have this complaint if not treated by hormone therapy, over half never even bring it up at a medical visit. Because the molecule has beneficial effects on the bone and potentially anti-estrogenic effects on the breast your gyno will be able to determine if this is the best for you given risks of medication as well. Of women with genitourinary syndrome in menopause so a great number of women stand to benefit by considering therapy.
Before therapy you need some evaluation: do you have an infection of the vagina, a bladder infection, or perhaps badder dysfunction that can be detected by urodynamics. Vaginal estrogen treatments are effective for all of the issues that occur with this syndrome. The doses of estrogen given do not cause estrogen blood levels to differ from women without the vaginal estrogen treatment. Women need to be treated with oral medication for about 3 months for full effectiveness, and there is a warning that the medication can cause thickening of the lining of the uterus which would need to be evaluated. Women experiencing unusual vaginal discharge or bleeding need to see their gyno to see if they have this complication.The boxed warning for ospemifene also states the incidence rates of thrombotic and hemorrhagic strokes (0.72 and 1.45 per 1000 women, respectively) and the incidence rate of deep vein thrombosis (1.45 per 1000 women)."These rates are considered to represent low risks in contrast to the increased risks of stroke and deep vein thrombosis seen with estrogen-alone therapy," the FDA said. Minor side effects can include hot flashes or vaginal discharge.