If you’ve watched my recent webinar on female sexual health, you may have been interested to know or surprised to hear that I prescribe vaginal estrogen cream to almost all my female patients once they reach their 40s. It may come as a surprise to many of you because, unfortunately, most doctors, even gynecologists, do not understand the significant benefits of this treatment.
Note: Because of the localized effects of vaginal estrogen, it does not confer the benefits of estrogen/hormone replacement therapy which is a separate topic.
Estrogen Creams and Cancer
You may have read about the correlation between hormone replacement therapy and certain cancers. It’s important that we dispel many of the myths surrounding this association, and we will do so in our article about hormone replacement therapy and cancer. However, vaginal estrogen is different. Low-dose vaginal estrogen is localized, and as such, none of the hormone enters the bloodstream. While this means that it will not have the protective effects of systemic estrogen in perimenopausal and menopausal symptoms, it also means that there are virtually no ill effects. In fact, low-dose vaginal estrogen is perfectly safe, even for women with breast cancer and clotting issues.
Why Does Vaginal Estrogen Make Sense?
The vaginal lining is a very delicate structure that starts to break down over time. When we are young, estrogen levels are sufficient to maintain the moisture and cellular structure in the vaginal lining. If we were to take a cross-section of the vaginal lining at a young age, it would look pillowy and soft with a nice thick cellular structure. However, over time, as estrogen production naturally diminishes, the cellular structure starts to break down, the vagina begins to dry, and the result is a flatter thinner cross-section that increases the risk of urinary tract infections and often causes vaginal dryness and pain during intercourse.
What Vaginal Estrogen Does
Vaginal estrogen can prevent or reverse these effects, allowing the vagina to retain a more youthful cellular structure. This reduces the risk of UTIs and makes sexual intercourse more enjoyable and less painful. This occurs with virtually no side effects, though every patient is different, and not all patients will require or be suitable for estrogen cream.
Dosage
For most of my patients, I prescribe a vaginal estrogen cream to be used only twice a week, at low doses. This small dose reduces any potential risk associated with estrogen. It may be tempting to start with a higher dose to see faster results, but this is ineffective and unnecessary.
The Bottom Line
Unfortunately, women’s sexual health is all too often ignored; women suffer through menopause and later years as a result. With proper management and simple solutions like vaginal estrogen, my patients can effectively manage their concerns and symptoms and enjoy their intimate life again.
Contact us to learn more about this and various other rejuvenation options. I look forward to seeing you at a consultation to discuss how we can best manage midlife together.