Couple Gets Genital Injections To Better Their Sex Lives
All About Vaginal Hormone Injections
Many women experience vaginal thinning and dryness during menopause. Find out why this targeted alternative to HRT can help.
By Kristen Stewart
Medically Reviewed by Lindsey Marcellin, MD, MPH
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When most women think of menopause, their minds jump to hot flashes and night sweats. However, changes within the vagina can occur as well, with the vaginal walls getting dryer and thinner. This can cause irritation and pain during intercourse.
Water-soluble lubricants may help, but if not, you may want to consider topical estrogen applied within the vagina as a type of localized hormone therapy for menopause treatment. “Very small amounts of estrogen cream bring about big changes in vaginal health,” says Charla Blacker, MD, a reproductive endocrinologist at Henry Ford Hospital in Detroit. “About a pea-sized application of estrogen cream for several weeks returns the vagina to a more youthful (and useful) organ.”
Estrogen can be applied in several ways. One is a vaginal injection — not with a needle and syringe but rather an applicator like those used for yeast infection treatments. Another possibility is an estrogen-impregnated ring that’s about 1.5 inches in diameter and placed in the vagina for three months, where it gradually releases estrogen over time. Another type of localized hormone therapy is a tablet containing estrogen that can be inserted vaginally.
With most types of vaginal hormone replacement therapy, or HRT, women use it more frequently in the beginning (except with the ring), often nightly until the tissue becomes healthy and then reduce usage to one to three times a week.
Vaginal Hormone Therapy Pros and Cons
General HRT comes with risks ranging from an increased chance of breast cancer to a greater likelihood of stroke and heart disease — it’s not a decision to be made lightly. One of the benefits of vaginal HRT for menopause treatment is its delivery right to the source of the issue rather than throughout the body, also referred to as a systemic treatment.
“All of the vaginal estrogens deliver the hormone exactly where it’s needed, to improve tissues without a significant increase in the systemic estrogen levels,” says Dr. Blacker. “There has never been a study that suggested that vaginal estrogens increase the risk of breast cancer. Most studies have not suggested that an increased risk of endometrial cancer is associated with vaginal estrogen use either, though this is less consistent.”
While direct vaginal hormone therapy has the benefit of not increasing the likelihood of other health problems, it should be noted that, because it doesn’t deliver estrogen systemically, it does not help with other menopause issues such as hot flashes, night sweats, and bone loss. (The exception to this is the Femring, which is specifically designed to deliver systemic therapy, says Blacker.)
Other downsides are that you might find the cream messy to use and, if you have arthritis, the rings may be difficult to remove.
Is Vaginal Hormone Therapy Right for Me?
For many women, the answer is most likely yes. “Luckily, almost any woman is a candidate for vaginal estrogens,” says Blacker. “Exceptions include women who have a history of an estrogen-dependent tumor such as breast cancer or endometrial cancer.”
Also, women who have allergies to ingredients found in the creams should probably consider another format such as the pill or ring. On the other hand, women who often get yeast infections might want to use the cream or pill since the ring may harbor yeast.
The cost of vaginal estrogen creams, rings, and pills varies, as does the coverage by insurance plans. Be sure to check with your insurance company and pharmacy for coverage specifics.
When it comes to balancing overall health with the health of your sexual life, talk to your ob-gyn to see if vaginal injections are a good option for you.
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