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Vaginal Estrogen Safe For Post-Menopausal Women
Although estrogen replacement had been linked to an increased risk of cardiovascular disease and cancers, a landmark new study demonstrates no rise in risk for women using topical estrogen for relief of genitourinary syndrome.
“It’s really important to differentiate between systemic estrogen replacement and topical estrogens,” says UCI Health urogynecologist Dr. Felicia Lane. “This new study shows that topical applications — unlike systemic estrogen replacement — do not increase the risk of blood clots, cardiovascular disease, osteoporosis or breast and endometrial cancers.”
What happens in menopause?
Menopause, which is defined as an absence of menstrual periods for 12 months, results in the reduction of circulating estrogen. Doctors sometimes treat menopausal symptoms such as hot flashes, night sweats and mood changes, with systemic hormone replacement therapy in the form of pills or patches.
These therapies, which were not included in the recent study, have previously been linked to cardiovascular and cancer risk. Lane still advises women to talk with their doctors about the benefits and risks of these systemic therapies.
What topical estrogen treatments are available?
Topical vaginal estrogen treatment can produce great improvement in just eight to 12 weeks. It can be applied in different ways:
Suppositories inserted in the vagina with an applicator two to three times a week at bedtime
Creams applied vaginally twice a week at bedtime
A ring, inserted in the vagina every three months by a provider or patient, that releases low doses of estrogen daily
Who shouldn’t use these topical treatments?
Women who are not candidates for vaginal estrogens — those who’ve had breast cancer or a recent stroke — may consider non-estrogen lubricants such as Vitamin E suppositories or prasterone cream. “These womeni need to have a conversation with their doctors about the right therapy,” Lane says.
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