The Desert “Down There”

Written By Jacqueline Riedel

Known formally as the genitourinary syndrome of menopause, or GSM, vaginal dryness is a common symptom during perimenopause (though for some women it doesn’t present until much later).

GSM can present in many ways:

  • itching

  • yeast infections

  • urinary tract infections

  • pain with sex

  • new sensitivity to touch (toilet paper, soap, tight clothing)

  • urinary urgency (“I need to pee - now!”)

  • leakage or loss of urine

  • getting up to urinate overnight (usually more than once, and even after limiting evening fluid intake)

The cause? Fluctuating estrogen levels lead to changes in collagen quality and alter the normal vaginal flora (bacteria and yeast that live in the vagina and keep it clean and healthy).

The solution? Often all that is needed to improve GSM is a topical vaginal estrogen product.

This type of estrogen is:

  • very low dose

  • only absorbed locally (so it doesn’t change your blood level of estrogen), and

  • appropriate for anyone with a vulva regardless of age (even your grandmom who keeps going to the doctor for urinary tract infections!).

Vaginal estrogen comes in a few formulations.

  • a cream, applied to the lower vagina and surrounding structures a few times a week;

  • a tablet or insert, applied two nights a week;

  • a vaginal ring, inserted and worn for 90 days.

Because of the low dose of estrogen in these products, they do no increase the blood levels of estrogen and are considered safe even in women who have had breast cancer.

For women who do not tolerate or improve with vaginal estrogen, there is a vaginal DHEA product that has been shown to provide excellent symptom improvement. Prasterone is a daily insert containing DHEA in palm oil. When metabolized in the tissues, DHEA is converted to estrogen and testosterone. For some women, the addition of testosterone provides the local relief they did not obtain with estrogen alone.

Symptoms that do not resolve with these simple interventions warrant further investigation by your gynecologist or PCPIf you suspect you’re suffering from GSM, see and consult with your medical team to discuss treatment options specific to your health and medical history.

This article is for informational purposes only and is not meant to diagnose or treat any medical condition. No doctor-patient relationship is formed through this media.

Jacqueline Riedel https://magnoliamidlife.com