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Suggest Treatment For Vaginal Dryness And Atrophy
Question: I am looking for a way to treat vaginal atrophy and dryness that will not increase my breast size. I have been on bio-identical estrogen and then just estriol and my breast keep increasing. Is it the yam based bio identical vs say a premarin ( horse urine) product. I am 65 but have a very active sex life with my spouse and the dryness and atrophy are interfering with my pleasure.
Brief Answer:
Vaginal estrogen is you best option
Detailed Answer:
First of all, let me say that this is a common problem that can be overcome. There are several options for you that I would recommend to any patient with a similar problem. First, though, I would say that you should not get too caught up in idea that 'bio-identical' is somehow more safe or natural. You are getting side effects of systemic estrogen, regardless of the form you are using. Also, the natural forms of plant estriol are fine, but they are not going to reach tissue levels in the vagina that are going to solve your problem. Here is what you should consider:
1. You can continue the plant based estrogen products for control of symptoms such as hotflashes
2. You should consider a vaginal form of estrogen (yes, I do not like the idea of pregnant mares being using to harvest estrogen). There are other options including a tablet (vagifem) and a vaginal ring (e-string). With either of these products, the amount absorbed into your blood stream is so small that you should not experience breast tenderness. This is especially true with the vagifem tablet
3. Consider a long-acting lubricant, such as Replens, made by KY
4. Consider a short-acting lubricant, such as Astroglide, for intercourse
If these are not working, then vaginal estrogen cream (estrace) is another option that will work.
Let me know if this helps.
Dr. Raichle
Vaginal estrogen is you best option
Detailed Answer:
First of all, let me say that this is a common problem that can be overcome. There are several options for you that I would recommend to any patient with a similar problem. First, though, I would say that you should not get too caught up in idea that 'bio-identical' is somehow more safe or natural. You are getting side effects of systemic estrogen, regardless of the form you are using. Also, the natural forms of plant estriol are fine, but they are not going to reach tissue levels in the vagina that are going to solve your problem. Here is what you should consider:
1. You can continue the plant based estrogen products for control of symptoms such as hotflashes
2. You should consider a vaginal form of estrogen (yes, I do not like the idea of pregnant mares being using to harvest estrogen). There are other options including a tablet (vagifem) and a vaginal ring (e-string). With either of these products, the amount absorbed into your blood stream is so small that you should not experience breast tenderness. This is especially true with the vagifem tablet
3. Consider a long-acting lubricant, such as Replens, made by KY
4. Consider a short-acting lubricant, such as Astroglide, for intercourse
If these are not working, then vaginal estrogen cream (estrace) is another option that will work.
Let me know if this helps.
Dr. Raichle
Above answer was peer-reviewed by :
Dr. Raju A.T
So if I understand this correctly then I need estrogen, but locally in the vagina itself. There are options other than Premarin which you would go to before premarin. ( I took premarin for years with no issues at all but my medical team changed it and added progesterone after a car wreck/head injury 4 yr ago. I stopped the progesterone within a few months as my body just did not like it. I had never been given progesterone, just estrogen after my hysterectomy)
You recommendations are in order:
Vagifem
vaginal rings
My concern with vaginal product is there effects on my male partner and yes we are exclusive and yes we enjoy oral. Is this a problem if using either of these?
Thank you.
You recommendations are in order:
Vagifem
vaginal rings
My concern with vaginal product is there effects on my male partner and yes we are exclusive and yes we enjoy oral. Is this a problem if using either of these?
Thank you.
Brief Answer:
There will not be a problem
Detailed Answer:
So it sounds like they do not want the oral estrogen because of concern regarding blood clots or stroke. That is fine. Your questions are excellent.
1. The vaginal products will NOT affect your partner
2. There is NOT a problem with oral sex with use of either
And yes, topical or tablet form of estrogen directly into the vagina will provide better delivery to the vagina AND produce few, if any, systemic / breast symptoms.
Dr. Raichle
There will not be a problem
Detailed Answer:
So it sounds like they do not want the oral estrogen because of concern regarding blood clots or stroke. That is fine. Your questions are excellent.
1. The vaginal products will NOT affect your partner
2. There is NOT a problem with oral sex with use of either
And yes, topical or tablet form of estrogen directly into the vagina will provide better delivery to the vagina AND produce few, if any, systemic / breast symptoms.
Dr. Raichle
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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