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Vaginal Estrogen Therapy

Why would you use estrogen in your vagina? Simple explanation is that vaginal estrogen is used to replace the estrogen that is no longer there. Many women who have gone through menopause suffer from Genitourinary Symptom of Menopause or GSM. This is basically a fancy medical term for VAGINAL DRYNESS. This issue does not just affect menopausal women. Women who have gone through chemotherapy, pelvic radiation, breast feeding, and certain medications can cause vaginal dryness. Either by the mechanism of action of medications OR by decreasing your estrogen levels causing menopause or menopause like symtpoms. Women with GSM complain of vaginal irritation,dryness, painful intercourse, and frequent urinary tract infections (UTI). Yes, lack of estrogen in your vagina may cause increased UTI’s! You are not alone, there are over 32 million women in the United States that report one or all of these symptoms. The most common complaint reported is painful sex, 75% of women report that as the most common symptom. 38% report vaginal itching and 15% report vaginal pain. Standard prescription therapy for treating GSM is the use of vaginal estrogen. Vaginal estrogen replacement can be by a ring, vaginal tablet and or vaginal cream. Most women find vaginal estrogen to be well tolerated with minimal side effects. There is little to no endometrial stimulation within your uterus. Which makes the likelihood of cancer of the uterus very low. Also vaginal estrogen works locally and has little systemic side effects, or concerns of breast cancer, stroke or clots. The negative to vaginal estrogen is that many women do not use the correct dosing of the vaginal creams. Some find it to be messy and a nuisance. However, the main barrier to use is misunderstanding of safety data. It is important to discuss any concerns about vaginal estrogen with your provider, and even more important to address the concerns you may be having about vaginal dryness. Vaginal estrogen replacement may be all you need to help alleviate the pain and discomfort you're having. If you have more questions, please contact me at

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