Women who think they have vulvar and vaginal atrophy (VVA) should speak to their gynecologist. There are a variety of treatments available, and a doctor can provide guidance on which to choose. Options may include…
Over-the-counter vaginal lubricants are often used to relieve sexual discomfort. They lessen the friction that occurs with intercourse and are used on an as-needed basis. Lubricants are not absorbed by the skin and need to be washed off after use.
Lubricants may be water-, silicone-, or oil-based. Choosing one may be a matter of personal preference. However women should know that oil-based lubricants are not safe to use with latex condoms, as they can damage latex and cause condoms to break. This increases the risk of an unplanned pregnancy or sexually-transmitted infection.
Vaginal moisturizers are also available over-the-counter, but they differ from lubricants. Moisturizers are applied every few days and are absorbed into the vaginal lining to keep it wet. They can work well for women who have daily vaginal dryness in addition to sexual discomfort from poor lubrication.
Low-dose Vaginal Estrogen
Low-dose vaginal estrogen is a longer-term treatment available by prescription. It helps improve genital blood flow and keeps the vaginal tissues moist and healthy. Vaginal estrogen is applied directly to the vagina in the form of a cream, ring, tablet, or suppository. Only low doses of vaginal estrogen should be used. Women who have had breast cancer should be sure to discuss this treatment with their doctor, as hormonal therapy may not be appropriate for them.
A drug called Osphena (ospemifene) was approved for postmenopausal women by the U.S. Food and Drug Administration (FDA) in early 2013. Osphena is an oral medication that works like estrogen to strengthen vaginal tissues. It can help some women who have painful intercourse. However, Osphena should be taken with caution, as the drug can thicken the endometrium (lining of the uterus). Women who have unusual bleeding should see their healthcare provider as soon as possible.
While not an official “treatment” for VVA, regular sexual intercourse can keep the vaginal tissues healthy, moist, and flexible.