Vaginal Estrogen Therapy: A Gold-Standard Treatment for GSM
What is Vaginal Estrogen Therapy?
Vaginal estrogen therapy is the most effective treatment for Genitourinary Syndrome of Menopause (GSM). It works by improving the quality of vaginal skin and tissues, thickening the vaginal canal lining, increasing natural lubrication, and restoring the normal pH balance of the vagina. Additionally, studies have shown that vaginal estrogen therapy can reduce the risk of urinary tract infections (UTIs).
Forms of Vaginal Estrogen Therapy
Vaginal estrogen comes in different forms, including:
- Cream – Applied inside the vagina using an applicator
- Tablet – Inserted vaginally with an applicator
- Ring – A flexible ring placed inside the vagina that slowly releases estrogen over time
Is Vaginal Estrogen Therapy Safe?
Yes! Local vaginal hormonal therapy has minimal to no systemic side effects when used as prescribed because very little estrogen is absorbed into the bloodstream.
Before prescribing vaginal estrogen, we assess your medical history, particularly for breast cancer or blood clots in the legs or lungs. In cases with such histories, we may consult your oncologist or vascular specialist. However, most specialists agree that vaginal estrogen is safe due to its extremely low systemic absorption.
Furthermore, research has shown that vaginal estrogen use does not increase the risk of cardiovascular disease or cancer.
Does Vaginal Estrogen Interfere with Sexual Activity?
It is recommended to wait at least 12 hours after inserting a vaginal estrogen tablet or cream before having sex. However, the risk to your partner is minimal and not considered a concern.
Final Thoughts
Vaginal estrogen therapy is a safe, effective, and well-tolerated treatment for GSM, helping women regain comfort, confidence, and quality of life. If you are experiencing symptoms of GSM, consult your healthcare provider to discuss whether vaginal estrogen therapy is right for you.
References
- Angelou K, Grigoriadis T, Diakosavvas M, Zacharakis D, Athanasiou S. The Genitourinary Syndrome of Menopause: An Overview of the Recent Data. Cureus. 2020;12(4):e7586. Published 2020 Apr 8. doi:10.7759/cureus.7586
- Bhupathiraju SN, Grodstein F, Stampfer MJ, et al. Vaginal estrogen use and chronic disease risk in the Nurses’ Health Study. Menopause. 2018;26(6):603-610. doi:10.1097/GME.0000000000001284
- AUGS – Vaginal Estrogen Therapy (PDF)
- Chen R, Wang JY, Lv K. Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Vaginal Symptom Severity in Postmenopausal Women. JAMA. 2022;327(3):283. doi:10.1001/jama.2021.22305
Genitourinary Syndrome of Menopause (Vaginal Health) | Menopause Care
