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. 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 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.