Tuesday, July 24, 2007

Local Estrogen replacement therapy

Topical or local application of estrogen to the vagina is useful to treat many conditions. The goal of such treatment is to reverse or diminish age-related changes to the vagina. There is limited systemic absorption of estrogens applied locally, yet locally it increases blood flow, reduces vaginal pH, and increases secretions. Topical replacement estrogen can be appropriate for peri-menopausal or post-menopausal women who have the following problems:

Vaginal dryness
Pain with intercourse
Recurrent bladder infections
Urinary urgency, or urge incontinence

Vaginal atrophy is an inevitable change with age as a result of estrogen loss that can be progressive. Women are often embarressed and don't often seek treatment. Restrictions on taking oral estrogen replacement due to potential cardiovascular risks makes vaginal atrophy more likely to occur, and can be addressed easily. Topical creams or even small suppository pills can be used. Women who have a history of breast or endometrial cancer, or undiagnosed bleeding should not use topical vaginal estrogen.