Estrogen works to heal thinned and dried layers of the vaginal tissues and thus achieving healing of the vaginal changes that occur in menopause. the amount of hormone prescribed should reflect the degree of changes, and aim to minimize any possible systemic effects. For some women there are only minor symptoms, others have bladder symptoms, recurrent urinary tract infections, stress incontinence, painful sex, irritating dryness or itching. Women who have these symptoms in menopause, are diagnosed with the genitourinary syndrome of menopause. It is commonly caused by the thinning of the vaginal walls, which begins with the lowering of estrogen levels as a woman ages. For the most part your gyno can tell by looking but are even pap tests to determine if this is the diagnosis, although your gyno can hear your complains and with the exam give you a diagnosis.
Generally gynos have recommended treatments depending on extent of the abnormalities, the duration of symptoms, and the minimization of risk. For those not wanting to use medication there is the MonaLisa Touch treatment. It is also thought that nonhormonal moisturizers such as coconut oil, or products such as Replens if you have mild symptoms, are not harmful, but they have very short term success and cannot fundamentally correct the tissue as the MonaLisa Touch therapy can. AS ovarian estrogen production keeps a young woman's tissues healthy, we can prescribe similar dosages of estrogen therapy and for decades this was the treatment of choice for this condition. Interestingly a medicine that actually has bone health effects has now also been recognized as an excellent painful sex treatment, it is ospemifene, or known by the brand name Osphena. 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. Osphena is also a systemic treatment that likely has positive effects on your bones as well as breast cancer prevention component. Although gynos estimate that virtually all women remaining sexually active in some way, 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. For some women that may mean just fantasies, but it's normal to feel some arousal with the fantasies, and if not, perhaps your tissues are not healthy after all. 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. Vaginal estrogen treatments are effective for most women and for all the symptoms and all of the issues that occur with the Gentolurinary Sundrome of Menopause.The doses of estrogen given do not cause estrogen blood levels to differ from women without the vaginal estrogen treatment. And this can be checked by your gynecologists. Women need to be treated for about 3 months for full effectiveness, and there have been rare cases of 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.