Vaginal Hormone Therapy
Low-dose vaginal hormones treat the vaginal and urinary changes of perimenopause and menopause, known as genitourinary syndrome of menopause (GSM): dryness, burning, painful intercourse, urinary urgency, and recurrent urinary tract infections.
What changes, and why
As estrogen declines through perimenopause and menopause, the walls and skin of the vagina become thinner, drier, and sometimes inflamed. That can show up as burning, irritation, and pain, especially during intercourse. Some women also notice urinary frequency, pain with urination, or more frequent urinary tract infections, as changes in the tissue shift the vaginal microbiome.
Doctors now call this genitourinary syndrome of menopause, or GSM. It replaced the older term vulvovaginal atrophy because the changes are not limited to the vagina.
Low doses, for local treatment
Estrogen, DHEA, and testosterone can each be used vaginally at a low dose to treat the vaginal and urinary tissue, as a cream, tablet, ring, or troche. Testosterone is prescribed off-label for women. Very little of a low local dose is absorbed into the rest of the body.
Hormones placed vaginally at higher doses can treat the whole body. That's systemic therapy, and you'll find it on our Hormone Therapy for Women page. If you already use a vaginal hormone, ask which kind you have, because a compounded cream applied vaginally can sometimes be a systemic dose.
Who it may help
- Vaginal dryness, burning, or irritation
- Pain with intercourse
- Urinary urgency, frequency, or discomfort
- Recurrent urinary tract infections after menopause
How it fits your care at AgeWell
Vaginal hormones are often one part of a broader women's hormone plan. They can also be combined with in-office treatments such as Votiva FormaV or MorpheusV. Because some vaginal hormones can be expensive without insurance coverage, we also help you find cost-effective ways to fill your prescription.
Common questions
Are vaginal hormones safe?
Low-dose vaginal hormones stay mostly local, so very little reaches the rest of the body, and they're appropriate for most women, including many who can't use systemic hormone therapy. We review your history with you before recommending them.
How is it different from hormone replacement therapy?
Systemic hormone therapy treats the whole body. Local vaginal hormones are a much lower dose aimed only at vaginal and urinary tissue.
Will insurance cover it?
Sometimes. AgeWell does not bill insurance, but your prescription may be covered by your pharmacy plan. If not, we help you find coupons or cost-saving pharmacies.