Vaginal estrogen linked to improved sexual health for some women

Among women who don’t take hormonal replacement therapy (HRT) after menopause, and even some who do, vaginally applied estrogen may help ease dryness and painful intercourse, a small U.S. study suggests. 

Many women have been reluctant to use HRT to ease menopause symptoms since 2002, when the federally-funded Women’s Health Initiative (WHI) study linked the treatments containing man-made versions of the female hormones estrogen and progestin to an increased risk of breast cancer, heart attacks and strokes.

For the current study, researchers compared how well locally-applied estrogens helped relieve vaginal pain and dryness among women who stopped HRT after the WHI results came out, as well as among women who stayed on HRT or resumed treatment after a temporary halt.

Women were most likely to use the vaginal estrogen if they reported pain during sex, and if they had stopped HRT, the study found.

Among the women who abandoned HRT and never went back, the participants using vaginal estrogen reported significantly higher satisfaction with their sex lives, the study published in Menopause also found.

“We would expect that the women with the most severe symptoms would show the greatest benefit and the group that stopped estrogen/hormone use after the WHI would be expected to develop symptoms and benefited the most,” senior study author Dr. Michelle Warren, of Columbia University Medical Center and the Center for Menopause, Hormonal Disorders and Women’s Health in New York, said by email.

Women go through menopause when they stop menstruating, which typically happens between ages 45 and 55. As the ovaries curb production of the hormones estrogen and progesterone in the years leading up to menopause and afterwards, women can experience symptoms ranging from irregular periods and vaginal dryness to mood swings and insomnia.

Vaginal dryness and painful intercourse are symptoms thought to result from atrophy of vaginal tissues because of falling estrogen levels. HRT has been shown to improve these symptoms by rebuilding vaginal walls.