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What are the best treatments for vaginal atrophy or dryness? |
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Vaginal atrophy, often called genitourinary syndrome of menopause or GSM, is a common condition that affects about half of individuals after menopause. It happens when declining estrogen levels cause changes to the vaginal and urinary tract tissues. These tissues become thinner, drier, and less elastic, which can lead to uncomfortable symptoms that affect your daily life and intimate relationships.
Symptoms can include:
- vaginal dryness
- burning or itching
- pain during sex
- vaginal bleeding or discharge
The good news is there are many treatment options available, ranging from over-the-counter (OTC) products to prescription medications. Here’s a quick guide to get you started. Your healthcare professional can help you find the right approach based on your symptoms and preferences.
1. OTC treatments
For many people, especially those with mild to moderate symptoms, nonprescription products provide relief and are often recommended as a first step before trying prescription options.
Vaginal moisturizers are products you use regularly, typically two to three times per week, to help maintain moisture in the vaginal tissues. They work by trapping moisture and providing longer lasting relief from dryness. Popular options include products containing polycarbophil, hyaluronic acid, or polyacrylic acid. Studies have shown that these moisturizers can improve vaginal dryness, reduce itching and irritation, and help with pain during sex.
Vaginal lubricants are different from moisturizers because they're designed to be used right before sexual activity to reduce friction and discomfort. They come in water-based, silicone-based, and oil-based formulas. Research suggests that silicone-based and polycarbophil-based lubricants may provide better relief than water-based options for some individuals. It's worth noting that oil-based lubricants shouldn't be used with condoms as they can damage them.
Many people find that using both a regular moisturizer and a lubricant during sex gives them the best results. These products are safe, low cost, and have minimal side effects, making them an excellent starting point for treatment.
2. Prescription treatments
If OTC products don't provide enough relief, several prescription options are available that have been proven effective in clinical studies.
Low dose vaginal estrogen is considered the gold standard treatment for vaginal atrophy. It comes in several forms, including creams, tablets, and rings that are inserted into the vagina. These products deliver small amounts of estrogen directly to the vaginal tissues, which helps restore thickness, moisture, and elasticity. Studies show that vaginal estrogen can improve symptoms by 60% to 80%. Because the dose is low and applied locally, very little estrogen enters the bloodstream, making it safer than systemic hormone therapy.
Vaginal DHEA (also called prasterone) is another hormone-based option that's inserted into the vagina daily. DHEA is converted to estrogen and testosterone in the vaginal tissues. Clinical trials have shown it can significantly improve vaginal dryness and pain during sex, with symptom improvement of 40% to 80%.
Ospemifene is an oral medication taken once daily that works differently from estrogen. It's a selective estrogen receptor modulator, meaning it acts like estrogen in some tissues but not others. Studies have demonstrated that ospemifene can improve vaginal dryness and pain during sex, with symptom improvement of 30% to 50%. Because it's a pill rather than a vaginal product, some people prefer this option.
3. Vitamins and supplements
Several supplements have been shown to help prevent vaginal dryness and enhance lubrication. Vitamin D, vitamin E, sea buckthorn oil, and DHEA are among the supplements that may help ease or reduce GSM.
Finding what works for you
Every individual’s experience with vaginal atrophy is different, so you may need to try different products or combinations of treatments before finding what gives you the best relief. Don't be discouraged if the first thing you try doesn't work perfectly. Your healthcare professional can work with you to adjust your treatment plan.
Vaginal atrophy is a chronic condition, so it doesn't go away on its own. However, with the right treatment, symptoms can be very well controlled, allowing you to maintain comfort, sexual function, and quality of life. |
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| Do you have any other questions for our menopause experts? Let us know at menopause@healthline.com, and the answer may be featured in an upcoming edition! |
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| HEALTHY TIP |
| Natural Remedies for Vaginal Dryness |
The remedy for vaginal dryness may already be sitting in your pantry or medicine cabinet. It turns out coconut oil is a popular natural remedy for dryness, thanks to its moisturizing and soothing properties. It can be used as a safe, chemical-free lubricant to reduce friction and discomfort during sex. Aloe vera gel and topical vitamin E oil are also on the list of natural treatments. Supplements including ginseng, black cohosh, and pine bark extract are often touted as natural remedies that may help with perimenopause symptoms. However, science-backed research on their effectiveness is lacking.
If you’re interested in natural approaches, the age-old practice of yoga may offer relief for menopause-related insomnia, mood changes, and even hot flashes. |
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