Break the silence... about vaginal symptoms

Vaginal therapy

Vaginal therapy includes vaginal tablets, creams, rings and suppositories which are inserted into the vagina to help relieve the vaginal symptoms of the menopause. These deliver oestrogen directly to the tissues of the vagina.They are easy to use and easy to stop. They are sometimes referred to as 'local therapy'.

For women who have only vaginal symptoms, it may be worth trying one of these local preparations.

If menopausal symptoms are more general, a form of treatment which circulates throughout the whole body (known as "systemic treatment" which is most commonly applied by tablets taken by mouth, or skin patches) may be more appropriate.

OK

Treatment for vaginal symptoms

If the vagina is dry and itchy, non-hormonal lubricants and special vaginal moisturisers can help. They can also make intercourse more comfortable. However, these preparations provide only temporary symptom relief but do not change the condition of vaginal atrophy which is caused by the lack of estrogen.

Hormone replacement therapy (HRT) given for general symptoms of the menopause can also alleviate vaginal symptoms in some women. Today, HRT comes in many forms – including tablets, patches worn on the skin, or skin implants. These systemic treatments (i.e. treatments that circulate throughout the body in the bloodstream) prevent or reverse vaginal changes in a large proportion of women but fail to resolve vaginal symptoms such as dryness in around a quarter. Therefore, and since those treatments affect the whole body, it is recommended to use vaginal treatment if symptoms only affect the vagina and urinary system.

Local estrogen therapy: Fortunately, oestrogen applied directly to the vagina is invariably effective at restoring vaginal health, helping alleviate vaginal dryness, itching, burning, soreness, and pain. For women who only have urogenital menopausal symptoms, these local treatments are often the only medication needed.

Oestrogen can be applied to the vagina by specially-designed vaginal tablets, creams, vaginal suppositories or by a ring that releases oestrogen slowly over time:

• Vaginal tablets are self-administered using a disposable applicator. The tablet binds to the wall of the vagina where it dissolves gradually, releasing hormone. One tablet is administered daily for the first 14 days; afterwards one tablet inserted twice a week suffices.
• Creams involve application of measured amounts with an applicator.
• Vaginal suppositories are usually inserted into the vagina without using an applicator.
• A hormone-releasing ring needs to be inserted into the vagina by a health care professional. It may remain in place for up to three months.

< Previous: Break the silence

Next: ...about urinary symptoms >