A recent survey showed that 63% of postmenopausal women experience vaginal
dryness that makes sex uncomfortable. Because of personal privacy and
embarrassment, only half of them reported this to their physician.
The vagina is very estrogen dependent, without it the tissues often become
thin and dry. Then during intercourse friction creates discomfort. Consequently,
vaginal dryness and
pain with intercourse have become more problematic with the dramatic decline in the use of systemic
hormone replacement therapy. Estrogen thickens the vaginal lining and
increases natural secretions.
While not all menopausal women experience vaginal dryness, there are solutions
to help those that do. First, there are over the counter vaginal moisturizers
and lubricants for intercourse that may suffice (often displayed near
condoms at retailers). Alternatively, consider utilizing low dose vaginal
estrogen. Topical preparations such as Premarin® and Estrace®
creams or Vagifem® tablets are FDA approved remedies. A recent study
demonstrated that a new lower dose of ½ gram of either estrogen
cream inserted into vagina just 2 nights each week is effective. This
does not change serum levels of estrogen, so it’s effects are confined
to the vagina. This is also true for Vagifem®. A good pneumonic to
help women remember is, use it every Wednesdays and a weekend night. It
may take about a month before symptoms initially improve. Finally, women
usually need to continue using vaginal estrogen to achieve the benefits.
While estrogen won’t correct a waning sex drive it can make sex more
comfortable. A little estrogen can make an improvement in the quality
of menopausal women’s life. Please don’t wait until your annual
exam to seek help.