Hormone replacement therapy
How can bioidentical hormones help vaginal dryness?
Q: I suffer from vaginal dryness and frequent urinary tract infections. The discomfort is ruining my sex life! Are there bioidentical hormones that can help?
A: It may be the case that you have an estrogen deficiency, which can lead to vaginal dryness and predispose you to frequent urinary tract infections (UTI’s).
At Women to Women we’ve had great success in recommending estriol vaginal cream or gel to our patients with vaginal irritation, dryness, and frequent UTI’s (cystitis). It may be all you need for your vaginal dryness and UTI’s.
Estriol (E3) is a bioidentical hormone that is produced in women’s bodies in large amounts by the placenta during pregnancy and in relatively small amounts by the liver and other fat tissue. Sometimes called the "forgotten estrogen," estriol is considered to be the most therapeutic estrogen for the vaginal lining, cervix and vulvar tissues, but exerts only a weak effect elsewhere in the body. Dr. Mills will sometimes recommend estriol cream even for her breast cancer patients. (See her article on estrogen and breast cancer.) Estriol is quite good at "plumping up" these delicate tissues to reverse vaginal dryness, irritation and atrophy.
Currently, estriol vaginal creams and gels can only be obtained from a compounding pharmacy.
A second, stronger form of estrogen known as estradiol (E2) is also sometimes prescribed to treat inflammation of the vagina (atrophic vaginitis). Bioidentical estradiol is commercially available in regular pharmacies in the form of vaginal cream (brand name Estrace), vaginal tablets (Vagifem), and an insertable vaginal ring (Estring, which needs to be changed every three months). Bioidentical estradiol is also available from compounding pharmacies.
Depending on the severity of your symptoms, one of the above bioidentical options may be just right for you. You may need to work with your provider for a while to get the right dosage. One advantage to using compounded bioidentical hormones is that your healthcare provider can customize your dose, combining hormones as necessary, expressly to meet your needs.
See our symptom section for an overview of additional natural measures you can take to help vaginal dryness.
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Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with an at-home version of the approach we've used successfully at our clinic for over 21 years. The Program includes our medical-grade nutritional supplements, phytoendocrine support and dietary and lifestyle guidelines (including recipes). It's worked for thousands of women, and we're always just a free phone call away to help make sure it works for you, too.
We’re always happy to welcome new patients to our medical clinic in Yarmouth, Maine, for those who can make the trip. Click here for information about making an appointment.
Related to this article:
References & further reading on bioidentical hormones and other forms of HRT
Original Publication Date: 12/07/2006
Last Modified: 01/10/2008
Principal Author: Marcy Holmes, NP, Certified Menopause Clinician