Keep Your Vagina Healthy: How to Stop Vaginal Dryness
LHJ: What are the choices -- and why would a woman prefer one over the other?
LS: There's a vaginal estrogen ring, which is super convenient. You insert a soft, flexible ring into the vagina, which releases a steady stream of estrogen directly to the vaginal tissues. You replace the ring every three months as long as you need it. My patients also love the vaginal estrogen tablet. You use a disposable applicator to insert a tablet into your vagina once a day for the first two weeks of treatment. Then you insert it twice a week until you no longer need it. The least expensive option is vaginal estrogen cream. You use an applicator to insert the cream into your vagina, usually twice a week. It's a little messy, but it has one advantage over the other choices: You can dab some on the outside tissues of the vagina to reduce irritation. Many women will get the cream for this reason, as well as use the tablets or ring. (Note that this dosage will not help symptoms such as hot flashes.)
LHJ: Do you need a prescription?
LS: Yes, but there's a non-prescription option for women who, despite their safety record, are wary about using a hormone. One over-the-counter vaginal moisturizer that I recommend to my patients is Replens, which adds moisture to cells, plumping them up and reducing dryness. Although they don't advertise it, these products also help normalize pH, fixing the foul odor and discharge. You generally need to use them twice a week, although you may find you need them less over time as your pH becomes better balanced.
LHJ: Will these remedies resolve issues with painful sex too?
LS: They'll help with wetness, but many women find using a lubricant, too, really makes sex more comfortable. There are two types of lubes: water-based and silicone-based. The water-based ones tend to be gloppy, sticky and don't last very long. And, unfortunately, they're what you're most likely to find at your local drugstore. Silicone-based lubes are much better -- they're less sticky and provide much longer-lasting slipperiness. They cost a little more and you may have to get them online. But if you search "silicone lubricant," at places like drugstore.com you'll find there's a wide range of choices.