vaginal atrophy – Hormone Pharmacist

Dyspareunia Part 3 DHEA for Vaginal Menopause Symptoms

Are you struggling with menopause symptoms like vaginal dryness, itching, irritation and even painful intimacy?

If so, you’re not alone. About 40 to 60% of menopausal women in a recent study complained of vaginal issues that make intimacy difficult or even painful.

As I mentioned in my last post, the hormone estriol has been used for years in Europe, to help relieve vaginal atrophy caused by the loss of hormones at menopause.

Canadian endocrinology researcher, Dr. Fernand LaBrie, is conducting clinical trials using DHEA in menopausal women with vaginal atrophy. [1. Labrie F, Archer DF, Koltun W, Vachon A, Young D, Frenette L, Portman D, Montesino M, Côté I, Parent J, Lavoie L, Beauregard A, Martel C, Vaillancourt M, Balser J, Moyneur É; members of the VVA Prasterone Research Group. Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause. Menopause. 2015 Dec 28.]

DHEA is a hormone that’s converted within the tissues into estrogen or testosterone when they’re needed. Dr. La Brie has published groundbreaking research in “Intracrinology,” this study of how hormones work within the cells. His research shows that DHEA, when given as a vaginal suppository, dramatically improves vaginal health, reduces painful intimacy and helps vaginal lubrication.

Women receiving vaginal DHEA showed no increases in the levels of DHEA or other sex hormones in their overall circulation. [2. Ke Y, Labrie F, Gonthier R, Simard JN, Bergeron D, Martel C, Vaillancourt M, Montesino M, Lavoie L, Archer DF, Balser J, Moyneur E; other participating Members of the Prasterone Clinical Research Group. Serum levels of sex steroids and metabolites following 12 weeks of intravaginal 0.50% DHEA administration. J Steroid Biochem Mol Biol. 2015 Nov;154:186-96. doi: 10.1016/j.jsbmb.2015.08.016. Epub 2015 Aug 17.]

Patients enrolled in the trials reported very mild, infrequent side effects. [3. Labrie F, Derogatis L, Archer DF, Koltun W, Vachon A, Young D, Frenette L, Portman D, Montesino M, Côté I, Parent J, Lavoie L, Beauregard A, Martel C, Vaillancourt M, Balser J, Moyneur É; Members of the VVA Prasterone Research Group. Effect of Intravaginal Prasterone on Sexual Dysfunction in Postmenopausal Women with Vulvovaginal Atrophy. J Sex Med. 2015 Dec;12(12):2401-12. doi: 10.1111/jsm.13045. Epub 2015 Nov 23.][4. Labrie F, Montesino M, Archer DF, Lavoie L, Beauregard A, Côté I, Martel C, Vaillancourt M, Balser J, Moyneur E; other participating Members of the Prasterone Clinical Research Group. Influence of treatment of vulvovaginal atrophy with intravaginal prasterone on the male partner. Climacteric. 2015 Dec;18(6):817-25. doi: 10.3109/13697137.2015.1077508. Epub 2015 Oct 30.]

DHEA is in Phase 3 Clinical Trials, which means the drug manufacturer is hoping to have a vaginal DHEA product on the U.S. Market in the next couple of years, pending FDA approval. DHEA is currently classified as a nutritional supplement by the FDA. It can also be compounded by a specialized pharmacy into a vaginal suppository or a cream.

Talk with your doctor to see if you might be a candidate to try DHEA for your vaginal menopause symptoms and you’ll also receive a report I’ve written about what I think is the best combination therapy for menopause.

Dyspareunia Part 2 Estriol for Vaginal Menopause Symptoms

Are you struggling with vaginal dryness, irritation and maybe even painful intimacy?

Menopause causes changes in vaginal tissue that make intimacy uncomfortable. One study showed 44% of menopausal women saying intimacy was painful, that’s called dyspareunia. Even women who weren’t sexually active complained of vaginal dryness, itching and irritation after menopause.

Last Thursday, one of my patents complained of what she bluntly called, “. . . the Sahara Desert between my legs.” Not coincidentally, I was counseling that patient about her prescription for estriol to treat vaginal atrophy. The fact that no one talks about it doesn’t make it less of an issue.

In my last post, I went over some FDA approved estradiol products that reverse vaginal menopause symptoms. Another option, vaginal Estriol, also called E3, is available in the U.S. from compounding pharmacies.

Estriol is one of the weakest bio-identical estrogens, exactly the same as an estrogen your body makes. Estriol has been prescribed as Ovestin® oral tablets or vaginal cream to treat vaginal menopause symptoms in Europe, Australia and the U.K. For over 20 years.

In the U.S., a compounding pharmacist can make up estriol prescribed by your doctor in a vaginal suppository, troche or cream. Because it’s not FDA approved, estriol is covered by only a few insurance companies. You’ll pay around $50 to $70 for a vaginal estriol prescription, but that’s at least $100 less than most of the commercially available vaginal products.

Estriol cream or suppositories are inserted vaginally once a day at bedtime, every night for a couple of weeks. After that, the dose is cut back to 2-3 times weekly. This regimen helps to build up vaginal tissue and reverse vaginal atrophy. Less frequent estriol doses help maintain that healthy vaginal tissue.

Since Estriol is a weaker estrogen, it’s not used as often by itself for hot flashes, but it can really help with vaginal issues. Talk with your doctor about the possibility of getting a prescription for estriol from a specialty compounding pharmacy.

There are some promising clinical trials going on with vaginal DHEA that I’ll tell you about in my next video, Part 3 in this series on treatment of vaginal menopause symptoms. To stay informed about when I upload new videos, subscribe to my channel on YouTube.

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

Thanks for watching and I’ll talk with you again soon.