With gynecologic oncologist, Beverly Long, MD
During or after menopause, it’s not uncommon for women to experience sexual dysfunction or irritation due to vaginal dryness. Next to hot flashes, vaginal dryness is the most common symptom to experience with menopause. Thankfully, this also means that there are several options for women dealing with these issues, including something as simple and safe as a topical estrogen cream, like Estradiol.
“A lot of women have dryness and sexual dysfunction after menopause,” says Dr. Beverly Long, an obstetrician and gynecologist with Sarasota Memorial. “Vaginal estrogen cream can really help with that, because estrogen is the hormone you lose after menopause.”
Vaginal Dryness & Recurrent UTIs
In addition to sexual dysfunction and general irritation, vaginal dryness can also lead to recurring urinary tract infections. “But vaginal estrogen can actually reduce recurrent UTIs,” says Dr. Long, “which are a problem for a lot of women.”
The Benefits of Extra Estrogen
With the body losing estrogen after menopause, the common sense solution is to add more estrogen to the system. And modern medicine has found several ways to do that, including patches and pills and hormone-releasing implants. But according to Dr. Long, there could be added benefits to opting for focused use of topical cream as opposed to a systemic intervention.
A vaginal topical cream such as Estradiol will, in the vast majority of women, effectively alleviate symptoms, and it does so without any of the risk that comes with taking estrogen in a continual systemic manner.
“Because it’s a local treatment,” says Dr. Long, “there aren’t any hard contraindications.” (This is doctor-speak for “There isn’t any evidence of possible serious negative effect.”)
A doctor’s prescription is still required for a topical estrogen cream, and a very small percentage of women may have an allergic reaction, but it’s far less likely to cause the serious problems that excess estrogen can cause if taken in a systemic manner.
The Dangers of Extra Estrogen
While topical creams focus the application of extra estrogen, systemic delivery options, like patches, pills and implants, continually release estrogen into the body over time and so can affect the whole body.
One particularly troublesome effect of this excess estrogen is that it can promote unchecked growth of the uterine lining. “And so you can get overgrowth of the uterine lining,” says Dr. Long, “and this can eventually turn into cancer.”
Know the Signs of Endometrial Cancer
According to the American Cancer Society, more than 66,000 new cases of endometrial (uterine) cancer will be diagnosed in 2023 and more than 13,000 women will die from it. But when detected early, endometrial cancer is often very treatable. Look out for these symptoms:
- Abnormal vaginal bleeding, spotting or other discharge (particularly after menopause)
- Pelvic pain
- Feeling a mass
- Weight loss
“But progesterone is like an anti-estrogen hormone that protects the uterus,” Dr. Long continues. “So if you’re using systemic estrogen and you have a uterus, you have to use progesterone.”
Using topical creams, however, does not bring the same risk and so does not necessitate taking progesterone. So for women dealing with discomfort post-menopause, Dr. Long recommends to at least start with a topical cream.
“It’s a very safe and very effective option,” she says. “Without any of the drawbacks.”
More Information
To learn more about gynecological cancer and the world-class collaborative care that patients receive at Sarasota Memorial Hospital’s Brian D. Jellison Cancer Institute, click here. And to learn more about the Thrive Integrated Oncology Program, providing support and wellness services both during and after treatment, click here or call 941-917-7827.