Declining estrogen levels around menopause effect the delicate tissues of the vulva and vagina. They become thin, dry and more easily damaged (atrophy). Around 50% of postmenopausal women will experience this Genito-urinary Syndrome of Menopause (GSM), which may cause painful intercourse, urinary issues, or vulval itch and irritation.
Depending on your specific symptoms the treatment options may include:
Currently there is insufficient evidence to support the use of vaginal laser therapy for GSM.
In milder cases of vaginal dryness it may be sufficient to use vaginal moisturisers and lubricants, but for more severe symptoms the most effective option is likely to be estrogen therapy. This can be in the form of vaginal estrogen creams or pessaries which specifically target the dryness. Women who also have hot flushes or osteoporosis however may benefit from systemic HRT; that is, estrogen taken transdermally (skin creams or patches) or orally. This delivers benefits throughout the body like relief of hot flushes and stronger bones.
Vaginal estrogens are very safe and effective treatment for menopausal vaginal dryness. There’s no need to take progestins to protect the uterus (like with systemic HRT) so there is no increased risk of breast cancer. Vaginal estrogens should be avoided in women who’ve had breast cancer though, due to a small risk of stimulating any remaining cancer cells. A more detailed explanation of the treatment options for GSM is available from the Australasian Menopause Society.
It is important to remember that there are many other causes of vulvovaginal symptoms like itching and pain, for example infections and skin conditions (some of which may be quite serious). Don’t assume that because you are menopausal it must be GSM, especially if treatments aren’t working. You should see your GP for an examination prior to starting any treatment.
If you can’t find the professional help you need for your menopausal symptoms then book a telehealth consultation today with a female WellFemme menopause doctor. Half-price consultations are available for women in regional, rural and remote areas who agree to complete short questionnaires for WellFemme’s Pilot Study.
Not sure if Telehealth is for you? Free trial consultations are available to find out how WellFemme can help with your menopausal symptoms.