*Content reviewed by HotPause Health Medical Advisor and Board-Certified OB/GYN Dr. Beverly Joyce

Potential Benefits of Vaginal Estrogen Therapy

Menopause is a natural biological process that marks the end of menstrual cycles in a woman’s life, often leading to various symptoms that can affect quality of life. Among the most effective treatments for alleviating menopausal symptoms, particularly those affecting vaginal and urinary tract health, is vaginal estrogen therapy. Menopause expert and board-certified OB/GYN, Dr. Beverly Joyce explains why this targeted therapy offers a beacon of relief for many women, bringing both physical and emotional benefits.

Understanding Vaginal Estrogen Therapy

Vaginal estrogen therapy involves the application of estrogen directly to the vagina in the form of creams, tablets, or rings. This local treatment works by replenishing estrogen levels in the vaginal tissue, helping to relieve symptoms such as vaginal dryness, itching, burning, and discomfort during intercourse, as well as urinary symptoms like urgency and recurrent urinary tract infections (UTIs).

Key Benefits of Vaginal Estrogen Therapy

• Improved Vaginal Health: One of the primary benefits of vaginal estrogen therapy is the restoration of vaginal health. Research studies show that estrogen helps increase vaginal lubrication, thickness of the vaginal walls, and elasticity, which can significantly reduce discomfort during sexual activity and improve overall vaginal comfort. [1] It also decreases yeast and bacterial infections by improving the pH of the vagina.
• Decreased Urinary Symptoms: Estrogen plays a crucial role in maintaining the health of the urinary tract. By enhancing the tissues of the urethra and bladder, vaginal estrogen therapy can lead to a decrease in urinary urgency, frequency, and recurrent UTIs, improving quality of life for postmenopausal women. A 2023 study published by the American Journal of Obstetrics & Gynecology, reported the frequency of urinary tract infection decreased by more than 50% in the following year, after using vaginal estrogen. [2]
• Enhanced Sexual Function: Vaginal dryness and discomfort during intercourse are common complaints among menopausal women, often leading to a decline in sexual satisfaction. Vaginal estrogen therapy can alleviate these symptoms, thereby enhancing libido and sexual function, contributing to a healthier sex life and improved intimacy.
• Low Systemic Absorption: Unlike systemic menopause hormone therapy (MHT) which introduces estrogen into the bloodstream, vaginal estrogen therapy focuses on the affected area with minimal systemic absorption. This localized approach reduces the risk of side effects associated with higher levels of systemic estrogen, making it a safer option for many women, especially those with specific health concerns related to hormone therapy.

Who Can Benefit from Vaginal Estrogen Therapy?

Vaginal estrogen therapy is particularly beneficial for postmenopausal women experiencing moderate to severe menopausal symptoms localized to the vaginal and urinary tract. It’s also a valuable option, and considered safe, for women who are not candidates for systemic hormone therapy due to health risks or personal preference.

A Word of Caution

While vaginal estrogen therapy offers numerous benefits, it’s not suitable for everyone. Women with a history of estrogen-dependent cancers, unexplained vaginal bleeding, or liver disease should discuss their medical history and concerns with their healthcare provider to determine the best course of action. In addition, not all vulvar and vaginal symptoms are due to estrogen deficiency. See your healthcare provider to rule out conditions like lichen sclerosus, or other skin conditions.

Conclusion

Vaginal estrogen therapy is a highly effective treatment for relieving the vaginal and urinary symptoms of menopause, with a low risk of systemic side effects. By improving vaginal health, decreasing urinary symptoms, and enhancing sexual function, it can significantly improve the quality of life for postmenopausal women. If you’re experiencing post-menopausal vaginal or bladder symptoms that affect your daily life, consult with your healthcare provider to see if vaginal estrogen therapy could be a beneficial option for you.

References:
1.Tomczyk K, Chmaj-Wierzchowska K, Wszołek K, Wilczak M. New Possibilities for Hormonal Vaginal Treatment in Menopausal Women. J Clin Med. 2023 Jul 18;12(14):4740. doi: 10.3390/jcm12144740. PMID: 37510854; PMCID: PMC10380877.

2. Efficacy of vaginal estrogen for recurrent urinary tract infection prevention in hypoestrogenic women Tan-Kim, Jasmine et al. American Journal of Obstetrics & Gynecology, Volume 229, Issue 2, 143.e1 – 143.e9