Estrogen is a naturally occurring hormone present in females that is secreted mainly by the ovaries. Its main function is female reproduction and sex characteristics but also contributes to cognition, mental health and immunity. As women age, and after some surgical procedures, hormone levels can decrease leading to irritative, and sometimes painful symptoms. Decreased levels of estrogen can cause atrophic vaginitis (irritation and inflammation of the vaginal tissue), vaginal dryness, dyspareunia (painful intercourse) and even make some women more susceptible to urinary tract infections (UTI). In postoperative patients, decreased estrogen can lead to delayed wound healing and wound complications.
Estrogen comes many different forms and in varying doses. Our preferred method of treatment involves placing a tablet vaginally before bedtime. Application of a tablet is typically less messy for the patient and bed time placement prevents the medication from falling out with activity.
Vaginal estrogen helps to create an acidic environment within the vagina. The increased acidity makes it harder for bacteria to thrive, therefore protecting against urinary tract infections. Along with proper hygiene, vaginal estrogen can reduce and even eliminate recurrent UTI’s in some patients.
Atrophic vaginitis and dyspareunia often go hand in hand. Lower estrogen levels within the vagina can lead to thin and dry vaginal tissue. By applying the medication vaginally rather than orally, the estrogen acts primarily on the vaginal tissue causing a direct effect on these tissues. Along with thickening the tissue, women will also experience increased vaginal lubrication leading to less painful intercourse.
Treatment with vaginal estrogen has been shown to be beneficial in restoring vaginal tissue to a healthier state. In pre and postoperative patients, vaginal estrogen thickens the vaginal tissue and increases blood flow to area. After surgery and during the healing process, it is important to have healthy tissue which promotes healing.
Estrogen therapy is not appropriate for everyone, so it is important to discuss treatment options with your physician.