BENEFITS OF HRT:

HELPING VAGINAL AND URINARY HEALTH

What HRT can do for you…

Approximately one-third of women over fifty years old experience some vaginal or urinary tract problems as a result of menopause.

Estrogen deficiency can result in vaginal dryness and painful intercourse.  It can also affect the bladder causing urination to become more painful, frequent, and urgent.  One of the more common symptoms is stress incontinence--urinary leakage under simple physical stress such as sneezing, laughing, coughing or sudden movement.  Recurrent urinary tract infections may also be a problem.

Estrogen has been shown to be very effective in relieving many of these symptoms. However, it does not relieve all types of incontinence because some may be due to mechanical or neurological problems.

If vaginal or urinary tract problems are the only symptoms of menopause that need treatment, low-dose topical therapy can be instituted that does not require the addition of progesterone to balance the stimulatory effect of estrogen on the uterus.

Premarin and Estrace vaginal cream have been used for years, but there is an increasing trend towards newer products.  Estring is a vaginal ring that is inserted (much like a diaphragm) and releases low-dose estradiol over a period of 90 days.  Estriol vaginal cream is formulated only by compounding pharmacies and is one of the most widely sold products in Europe under the name Ovestin.  Estriol offers women one of the lowest doses of estrogen to control uro-genital symptoms.

If you are already on oral or transdermal (patch or cream) estrogen, you may not need to use the vaginal preparations.

What are your needs?

 

Ask yourself:

Am I experiencing vaginal dryness or painful intercourse?

Am I having "bladder problems" such as painful and frequent urination or stress incontinence?

 

Additions/Alternatives to HRT

 

Vaginal moisturizers

 

A variety of vaginal moisturizers are on the market in both gels and suppositories. It is important to choose one that is  water-based because products with excessive oils may disrupt the natural balance of the vagina.

 

Soy products

 

There is conflicting evidence as to whether oral soy supplementation may be helpful in controlling vaginal dryness.  It may have other benefits, so there is little harm in trying it.

 

Vitamin E

 

Although there are no studies to confirm its effectiveness, many women have reported success using oral vitamin E 400 IU daily for vaginal dryness.  Other women have reported success using it vaginally, by first puncturing the end of the capsule before insertion. Like soy, it may help in the prevention of other diseases, so there is little harm in trying it.

 

Kegel exercises

 

These exercises should be the first choice of treatment for stress incontinence. They tone the bladder and the vaginal area and have proved very helpful for many women.

Benefit to Risk 

The dose used in topical vaginal treatment is usually very low, so the benefits clearly  are greater than the risks.  With most of the creams, their use can be reduced to just several times a week after the first few months. This reduces the body’s exposure to estrogen even further.

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