Treatment Options for Vaginal Atrophy
Not all women find vaginal atrophy to be a problem. But if you are distressed by the symptoms and want intervention, over-the-counter, non-hormonal products are the first line of help.
Some women find that non-prescription treatments work well, especially for mild symptoms. Non-prescription treatments are hormone-free and have few side effects and are considered an appropriate and ideal first-line therapy. They are applied locally and act immediately. Moisturizers, unlike lubricants, are designed for internal vaginal use and provide longer lasting relief of vaginal dryness, compared to lubricants.
SOGC Recommendations and Treatment Considerations:1,2
“Vaginal moisturizers applied on a regular basis have an efficacy equivalent to local hormone replacement for the treatment of local urogenital symptoms such as vaginal itching, irritation, and dyspareunia, and should be offered to women wishing to avoid use of hormone replacement therapy.”
Women who have pain during intercourse because of overactive pelvic muscles can learn how to relax those muscles by using a device called a vaginal dilator or with physical therapy.Having regular sexual activity, with or without intercourse, also can help relieve symptoms, as does allowing enough time to become aroused. If non-prescription products are not effective, local vaginal estrogen is a Health-Canada approved therapy that has proven effective.
Two types of estrogen are available: topical and systemic.
- Topical (vaginal) estrogen is applied to the surface of the vagina. Studies have shown that topical estrogen is a very effective treatment. Topical treatment doesn’t have the same health risks of systemic estrogen because only small amounts of estrogen reach the bloodstream.
- Systemic estrogen, also called hormone therapy, is taken as a pill, patch, gel, or spray. Systemic estrogen affects the whole body and has some health risks, such as heart attack and blood clots. If you’ve had breast cancer, talk with your doctor about what treatment is best for you. Limiting or avoiding estrogen can help prevent a return of breast cancer. Systemic estrogen, estrogen taken orally as in hormone therapy, should not be used for symptoms that involve vaginal atrophy only.