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The Case for Vaginal Estrogen
Observations from an integrative medicine physician
“Sex was painful,” she said. Three years post-menopause, my patient had no other bothersome symptoms. No hot flashes, no night sweats, no moodiness, nor many of the other complaints menopausal women sometimes have. “But I don’t want to take hormones, because my mom had breast cancer.”
As an integrative medicine physician who focuses on women’s health, I have versions of this conversation often.
Estrogen and progesterone, the predominant female hormones, decline dramatically during menopause. Testosterone production, which keeps muscles strong and libido intact, also drops, but assuming a woman still has her ovaries, this happens much more slowly. Lower levels of hormones may be associated with a variety of symptoms including hot flashes, night sweats, moodiness, or difficulty focusing — as well as increased risk of heart disease and bone loss that can lead to osteoporosis. One of the most uncomfortable symptoms, for more than 50% of women between the ages of 51 and 60, is vaginal dryness.
But vaginal dryness doesn’t tell the whole story. Often, what is felt is burning and not just during intercourse. Women may experience pain when they walk. Wiping may cause bleeding. And as women age into their sixties, seventies, and eighties…
