Is Vaginal Estrogen Safe for Menopausal Symptom Relief?
Common symptoms of menopause
Genitourinary syndrome of menopause is a term used to describe symptoms that typically accompany menopause, and may begin in the years leading up to menopause as well. Someone with genitourinary syndrome of menopause may experience symptoms of:
vaginal dryness
vaginal pain - often described as burning
vaginal itching
urinary incontinence
light bleeding with intercourse
pain or discomfort with intercourse
recurring urinary tract infections (UTIs)
frequent urination
urinary urgency
This occurs as a result of a decrease in estrogen production. Less estrogen means the vaginal tissues become thinner, drier, and more frail, leaving you susceptible to tissue tearing, pain, and further dysfunction of the pelvic floor region.
Estrogen and the risk of breast cancer
Breast cancer is the most common cancer among women. There is a lot of buzz around the use of estrogen and increased risk of this type of cancer, which leaves many women confused and afraid. It is suggested that estrogen taken as hormone replacement therapy (HRT) can increase the risk of cancer recurring, in those with a history of breast cancer. For this reason, many physicians will advise those with a personal or family history of breast cancer against use of estrogen therapy. Of note, this association is much more complex than I’m describing here and factors including the type of HRT, dosage, duration of use, and person’s age, are all factors at play for physicians to consider when they make their recommendations. What’s most important to understand is that this association and risk is specific to systemic estrogen. This is different from vaginal estrogen, which is more localized and will be described next.
Is vaginal estrogen safe?
In contrast to systemic estrogen as HRT, vaginal estrogen is prescribed typically as a cream or tablet/suppository that is applied to and acts locally at the vaginal tissue to address the symptoms associated with genitourinary syndrome of menopause. Many medical providers have been advocating for the safe use of such treatment for years, while others have not seemed to get on board with this. The most recent research, published just this month, has helped to clarify some confusion and can serve as a great point of discussion between you and your provider. Here are the highlights:
Healthy women, aged 50-60, without a history of cancer or hormone treatments were included in this nationwide study, in Denmark.
Women were exposed to the therapy for more than 4 years and at a dosage higher than the typical maintenance dose.
The use of vaginal estrogen tablets was not associated with increased breast cancer rate, compared to those who never took the treatment.
There was no association between breast cancer and treatment intensity (dosage) and duration of use.
What you can do next
If you’re bothered by symptoms of menopause, speak with your doctor about treatment options and consider providing this article as a talking point.
See a pelvic floor therapist for an individualized evaluation and treatment plan that works in conjunction with your vaginal estrogen.
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