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Friday, January 15, 2016

DHEA Treatment of Vaginal Atrophy

Painful sex is a seldom talked about, but frequent problem in women. Generally speaking painful sex, also called dysparunia,  as women age is due to VVA, the most prominent symptom of what is now more accurately called genitourinary syndrome (GUS) of menopause. It is due to lower levels of estrogen, and decreasing male hormones, even those of the adrenal gland. Making use of the fact that adrenal hormones themselves can affect the vaginal tissue, and the fact that some of the male hormones are converted to estrogen there is now a new treatment, DHEA that has been shown to be effective according to a new study published in Menopause. When women use lubricants for sex relief of dryness is very temporary, in some cases making sex possible, but rarely in making any symptoms improve other than intercourse. Vaginal moisturizers are somewhat more helpful in relieve symptoms of vaginal burning and itching at times other than at times of sex, but have no ability to fundamentally change the tissue itself. Hormonal treatments are very successful at correcting what is wrong with the superficial layers of the vagina and the vulva; but there's not been good evidence that they can remodel the underlying layers of the vaginal support anatomy. For that other therapies including surgery, mesh products, or non-surgical therapies such as laser or radiofrequency are necessary to improve the function of the pelvic floor itself. Hormone treatments given orally, by creams, or in injections can affect the vaginal wall; but it's healthier to use local treatments so that a women is not significantly exposed to the risks of the higher blood levels of these hormones. Since the successful recent studies Medscape quoted the lead author, of the DHEA vaginal treatement study, Fernand Labrie, MD, PhD, CEO of EndoCeutics Inc, Quebec City, Quebec, Canada, and saying that he expects approval by the US Food and Drug Administration this year. The company EndoCeutics is developing 0.5% suppositories of DHEA that has shown both tissue improvement, improvement in the pH, and patient satisfaction when used for 12 weeks compared to the use of placebo treatments. The researchers point out that this therapy has not been tested in breast cancer patients. MonaLisa Touch therapy and Femilift therapy has been tested in breast cancer patients, but neither is specifically approved by the FDA as vaginal therapy although the fractional laser technology is FDA approved for gynecologic use.


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