Hormone Pharmacist

Hormones: Clear and Simple

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Dyspareunia Part 1 Treatment of Vaginal Menopause Symptoms

Dyspareunia Part 1 Treatment of Vaginal Menopause Symptoms

Some women in menopause experience something called vaginal atrophy.  This can lead to intimacy issues that might have a negative impact on your relationship.

Of course, the first thing you need is understanding and patience from your partner with the changes in your body during menopause, but there are treatments that can reduce vaginal symptoms.  Over the next few videos, I’ll explain some of these treatments

The decreases in estrogen and testosterone that your body experiences at menopause cause the layers that make up the vaginal wall to change dramatically.

In a recent survey of 3000 post-menopausal women [1.Wysocki S, Kingsberg S, Krychman M. Management of Vaginal Atrophy: Implications from the REVIVE Survey. Clinical Medicine Insights Reproductive Health. 2014;8:23-30. doi:10.4137/CMRH.S14498.]
• 55% said they had vaginal dryness
• 44% reported dyspareunia – painful intimacy
• 37% complained of vaginal irritation
• 60% said these symptoms affected their enjoyment of sex

The REVIVE survey showed these women were hesitant to talk with their doctors about these issues.

There are effective treatments for vaginal dryness and painful intimacy.  You don’t have to just “Get used to it.”

Over the counter lubricants may help with mild vaginal dryness, although about 40% of the women surveyed said that Replens®, K-Y® and Astroglide® had not worked for them.

Hormone replacement products can reverse menopausal vaginal atrophy.

Estrace® vaginal cream, Estring® vaginal ring and Vagifem® vaginal tablets all  contain estradiol, exactly the same as an estrogen your body used to make.  Estradiol is very effective at restoring vaginal health and reducing vaginal menopause symptoms. [2.Mac Bride MB, Rhodes DJ, Shuster LT. Vulvovaginal Atrophy. Mayo Clinic Proceedings. 2010;85(1):87-94. doi:10.4065/mcp.2009.0413.]  Cash prices for commercially available estradiol products for vaginal atrophy range from $175 to $375. [3. Estrace® pricing information from goodrx.com] [4. Estring® pricing information from goodrx.com] [5. Vagifem® pricing information from goodrx.com]  They should be covered by insurance.

Avoid Premarin® vaginal cream because it has 10 or more horse estrogens you don’t need.

You may have seen ads for Osphena® featuring “Patti,” a woman in her 50s who is embarrassed but talks about painful sex after menopause.  Osphena® is an estrogen blocker that also helps reduce vaginal dryness.  A downside of Osphena® is that it can cause hot flashes.  The cash price of Osphena® is around $180 for 30 oral tablets. [6. Osphena® pricing information from goodrx.com]

Two more options for vaginal symptoms are only available in the U.S. from a compounding pharmacy.  I’ll tell you about those in my next 2 video posts.  If you subscribe to my YouTube channel, you’ll be the first to know when I upload new videos.

Join me for hormone updates at hormonepharmacist.com, where I have lots more useful, practical information about the best treatments for all your menopause symptoms.

Thanks and I’ll talk with you again soon.  Watch for Part 2 of my series on Dyspareunia and its treatment with estriol.

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Menopause Symptoms – Night Sweats, Insomnia and Progesterone

Are you getting close to 50?
Having trouble sleeping?
Waking up soaked?
Having a hard time getting back to sleep?

If so, you may be experiencing your first symptoms of menopause.

Night sweats, insomnia and hot flashes during the day are caused by the drop in your estrogen and progesterone levels at menopause.

There are a lot of options out there that can be used to relieve your night sweats and insomnia.  But for women with the most severe night sweats who just can’t sleep through the night, Progesterone replacement is the key.[1. Eichling PS, Sahni J. Menopause related sleep disorders. J Clin Sleep Med. 2005 Jul 15;1(3):291-300. Review. PubMed PMID: 17566192.]

Progesterone isn’t the same as progestins, powerful synthetic hormones that work LIKE progesterone, but don’t even come close to replacing the progesterone your body needs.

Here are some facts you need to know about progesterone:
1. Progesterone is sometimes called “bio-identical progesterone,” which means it’s chemically exactly the same as the hormone your body makes (or at least used to make)
2. Progesterone helps menopausal women have fewer night sweats, sleep better and even have fewer hot flashes during the day.
3. Progesterone has helped European menopausal women sleep for decades.  In a survey of 100 thousand French menopausal women,  the women who took Progesterone had lower breast cancer rates than women who took medroxyprogesterone, the most commonly prescribed progestin in the U.S..[2. Regidor P-A. Progesterone in Peri- and Postmenopause: A Review. Geburtshilfe und Frauenheilkunde. 2014;74(11):995-1002. doi:10.1055/s-0034-1383297.][3. Stanczyk FZ, Hapgood JP, Winer S, Mishell DR. Progestogens Used in Postmenopausal Hormone Therapy: Differences in Their Pharmacological Properties, Intracellular Actions, and Clinical Effects. Endocrine Reviews. 2013;34(2):171-208. doi:10.1210/er.2012-1008.][4. Fournier, A., Berrino, F., Riboli, E., Avenel, V. and Clavel-Chapelon, F. (2005), Breast cancer risk in relation to different types of hormone replacement therapy in the E3N-EPIC cohort. Int. J. Cancer, 114: 448–454. doi: 10.1002/ijc.20710][5. Fournier A, Fabre A, Mesrine S, Boutron-Ruault M-C, Berrino F, Clavel-Chapelon F. Use of different postmenopausal hormone therapies and risk of histology- and hormone receptor-defined invasive breast cancer. Journal of clinical oncology : official journal of the American Society of Clinical OncologyJournal of clinical oncology : official journal of the American Society of Clinical Oncology. 2008;26(8):1260-1268. doi:10.1200/JCO.2007.13.4338.]

Progesterone is readily available from any pharmacy in the U.S., as an FDA approved oil filled capsule for menopause symptoms. Progesterone is also available from compounding pharmacies in other dosage forms like sublingual troches and transdermal creams.

I’m here to help you understand the sometimes confusing world of hormones for menopause.  I’m constantly looking at the latest research on hormones and breaking it down so it’s easy to understand.

Thanks and I’ll catch you on my next post, which touches on intimacy issues in menopause.

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Menopause Symptoms: The Best Treatment For Hot Flashes

Menopause Symptoms: The Best Treatment For Hot Flashes

Are you struggling with the symptoms of menopause?

• Hot flashes making you crazy?
• Night sweats keeping you awake?  Maybe your partner too?
• Can’t get back to sleep?
• Feeling depressed?
• Cloudy thinking?
• Irritable?
• Loss of desire for your partner?

If you’re 45 to 50 and starting to experience hot flashes, night sweats, difficulty sleeping and maybe even vaginal dryness and painful sex . . . you’re not alone.

Somewhere close to 6000 women go into menopause in the US every single day.  That’s over 2 million women a year!  Some women sail through menopause with no issues but a lot of women have pretty bad symptoms.

Maybe that’s you?

75% of menopausal women have hot flashes – uncontrollable explosions of heat that take over your whole body.  You’ll sweat profusely, tear at your clothes and want to pour ice water on your head.

You can’t run away from a hot flash.  You just cool off as best you can and wait until the fire inside dies down.

[Read more…]