How to treat genitourinary syndrome of menopause with local estrogen
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- เผยแพร่เมื่อ 1 ส.ค. 2021
- How to treat the genitourinary syndrome of menopause with local estrogen// Tired of dryness or pain down there at menopause? In this video, I am going to discuss the 6 different types of vaginal estrogen products that treat genitourinary syndrome of menopause, which is the medical term for vaginal dryness and vaginal pain. This video will teach you the ways in which you can use vaginal estrogen and that there are many options for your symptoms to choose from.
#Menopause #GentiourinarySyndromeOfMenopause #HeatherHirschMD
1:50 Safety of vaginal estrogen
3:29 vaginal ring
4:22 Vaginal creams
6:42 vaginal insert
8:18 vaginal suppository
10:47 vaginal DHEA
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Disclaimer: This is not direct medical advice. These opinions are my own and don't represent those of my institution. These videos are for educational purposes only. None of the items are sponsored, however, I am a participant in the Amazon Services LLC Associations Program, an affiliate advertising program designed to provide a means for us to earn fees by linking to amazon.com. You do not need to purchase directly from my link. Ultimately, all recommendations and opinions of products are my own.
Link to the study mentioned in this video: pubmed.ncbi.nlm.nih.gov/28816...
• How to treat genitouri...
What did you try and what did you find success with? Are you interested in my review on over the counter options? Happy Monday!
Who thought I would be free from hirsutism Dr iyaremoses on TH-cam did help me get rid of hyperthyroidism with herbs medications.
I was facing hirsutism, I suffered until I meet Dr iyaremoses on TH-cam, who cured me from it for more information you can reach him out on TH-cam
Thank you for teaching this it is important for me. I have asked my GYN she said it is not good that i might get cancer. what is the over the counter option?
Great video! Concise and informative. Thank you for helping educate women. I had a hysterectomy and went into surgical menopause. I had no idea what was happening when I saw my lady parts shrinking and developed chronic UTI's. I was not informed pre surgery by my doctor. A lot of my pain could have been avoided. I am now using compounded vaginal and topical estrogen along with testosterone and finally seeing improvements. Our young girls need to be educated about GSM in health ed in school. It's a part of life! Most women I encounter have never heard of it and don't know it is a part of perimenopause and menopause. They really don't know what is happening to their bodies. I didn't!
Thank you for all that you do! Its so frustrating to me that the entire healthcare system has very little education on this subject. We have to turn to TH-cam for help!
Thank you, thank you, thank you. I appreciate you being willing to share your knowledge with others. You've given me hope and confidence that my symptoms can improve, it won't be cost prohibitive and it's safe to use!! 🙏🏻
Very informative! thanks
Glad you enjoyed it!
I suffered from severe hot flashes for over ten years and I finally got an RX for estradiol and I absolutely cannot believe how well this had worked. I go to a local VA hospital for my care and they are clueless on women’s care. I originally had an RX for Premarin but there is none to be found from the manufacturer they tell me. I tried Premarin a few years ago for a short time but I kept getting BV. I’m hoping this works to help my PH get to normal levels.
Your channel amazing 🤩 You have helped me So Much! Thanks 🙏
Awesome thank you!
@@heatherhirschMD I truly mean what I said! Not feeling alone in the struggle to get back a healthy relationship with your partner and yourself is priceless. You’re a star 🌟 in my book! Thx Dr. Hirsch you rock 🙌🏼
Thank you !
I have a grade 1 uterine prolapse and the E-string just kept falling out. The estradiol cream works great for me. I buy multipacks of disposable applicators with measurements. You only need 1 gram, not a full applicator so it's not messy at all, just use a panty liner.
I wish I could find someone like you Dr Hirsch in my area.
Same! One flawed study ruined our ability to get rx for estrogen forever!
OMG, thank you for this! I’ve been using Premarin since November and it has been huge blessing to me. And I’m glad to hear that you recommend it for the vestibule - that is currently my last remaining painful area and I have started dabbing the Premarin there a little more often. I’m alternating with hyaluronic acid because I’m finding that to be very soothing.
Hey thanks for that tip.
What hylaronic acid do you use where can I find it?
@@graciequiroz7443please share the hyaluronic acid you use it might help others too. Thank you !
What about sex? How does an active sex life influence my choice? Will estrogen damage my partner? Can I use lube? will any degrade sex toys or condoms? Can you address this please? Why skip such an important aspect? It further perpetuates the idea that we are no longer sexual beings.
Do you have a video on DHEA?
Started Imvxxy about 3 weeks ago. So far so good, there is minimal mess like u have with creams & V almost feel back to normal. I did have some bleeding/spotting so I do twice a week
I’m using Vaginal oestrogen. Just recovering from a abscess in the vaginal area. So terribly painful. Taking antibiotics. I’m hopeful the oestrogen helps. Thanks so much from Mary in England
Ive heard if u have your cervix you suppose to take progesterone too..I wonder if its safe to use only the estradiol vaginal crwam I do not want to take HRT had bad side effects but just the estradiol cream is what helped me for my UTIs
Need to try something else. Been on topical estradiol and tesosterone cream and burning is bad as ever. Was thinking about E String. It's terribly expensive. Was thinking about E STring.
Are some of the treatments you discussed more or less likely to cause blood pressure issues? I tried yuvafem but it raised my blood pressure for 24-48 hours after every insert
Great video. Thanks.
I am 4 months into HRT and have just used the cream. It is messy.
My issue is urinary urgency. I hate the panty pads.
What system do you think is best for urinary issues?
What is the best cream for post menopause does it help with urine leakage please thank you ♥️
Love your videos!
On E patch and oral nightly progesterone (postmenopausal). Can I use estradiol vaginal cream if I have a new ovarian cyst since it’s local to the vagina/ vulva?
Who thought I would be free from hirsutism Dr iyaremoses on TH-cam did help me get rid of hyperthyroidism with herbs medications.
This is valuable information! Unfortunately, my gyn is very reluctant to give me much of it because my mom had breast cancer. I can’t believe how much women suffer needless after menopause because we don’t have a clear protocol for prescribing estrogen. It would alleviate so many urinary and bladder issues as well as vaginal dryness and atrophy (which is not just an intimacy issue!). My dilemma is finding a gyn who is willing to consider more aggressive prescription of estrogen given my family history.
From what I understand, local estrogen to the vagina does not increase your chances of breast cancer.
You can take the research papers to your gyno and “teach” her/him that she doesn’t have to deny you treatment based on the research.
Dr Heather. What would be the solution for Stress incontinence and Vaginal Atrophy?? Have you heard of a device called EFEMIA it's placed vaginally to press the urethra alleviating leakage but I'm wondering how effective it really is??
Can you alternate vagfem one time and the next time that week i use Replen s? Thank you
Very informative! Do you have any insight as to which, if any, of these products are covered by insurance? And Would you be able to list or link these products with the correct names? Thank you so much!
Who thought I would be free from hirsutism Dr iyaremoses on TH-cam did help me get rid of hyperthyroidism with herbs medications.
I was facing hirsutism, I suffered until I meet Dr iyaremoses on TH-cam, who cured me from it for more information you can reach him out on TH-cam..
I was facing hirsutism, I suffered until I meet Dr iyaremoses on TH-cam, who cured me from it for more information you can reach him out on TH-cam..
Will Vagifem tablet then help with vulva burning/dryness then or should I use the cream? Thank you.
Just curious if lack of estrogen cream/untreated GSM can result in blood clots in urine as a symptom. Thank you.
When you take vagifem if you insert it lower will that help more with the driness?
What if you have a bleed please thank s ♥️
I have a question I can’t find the answer too so maybe you could ?
I have just started taking estradiol Vaginal inserts 10 mcg twice a week
I am experiencing spotting and cramps like a period is this normal in the beginning ?????
I have a question that I can’t find any answers to
If I’m on ERT cream but I still have painful sex and vaginal dryness can I also use a vaginal estrogen in addition to my transdermal estrogen?
But I want the benefit of a systemic estrogen as far as preventing diseases
Hi, I'm 64, menopause started at 58/59. I have vaginal atrophy. October i had breakthrough bleeding. December I had an ablation done. My pcp norr obgyn want me to have HRT. What are your thoughts? Vaginal dryness is very painful with bleeding
Could the creams cause a yeast infection?
Doctors conflict on whether there is systemic absorption. I hope there is.
Oh, and my gynecologist recommended Replens for vaginal dryness. I highly recommend it.
I’ve been using Premarin and it’s been working great. I’m using 1.5 3x a week. I also put a good amount (more than pea size) to my vulva area.
PERFECT!
I was wondering if you've noticed a cough or scalp hair thinning with premarin? I had to discontinue it.
Hello, thank you for all of your information. It is so helpful. I am on HRT, Estradiol 1mg and progesterone 100 mg, test 1 ml cream. My question is this, can you use vaginal Estrogen as a compliment to other HRT? I still have issues with atrophy/ and all things discussed in this video. I have been on HRT for years with great success, but for this.
I’m not a dr, but have experienced surgical menopause, starting 10 years ago. This confused me before I was told, but only the Estriol (NOT to be confused with estradiol. ESTRIOL is the vaginal estrogen that you can get in OTC Benzwecken suppositories or Mother’s Dose cream that goes on the vulva. Mothers dose prob has estrogen & estriol, so I’d make sure it is the “Estriol”. I suffered for almost 10 years with sudden dryness & constant UTI’s until I found ESTRIOL. This was my experience, so I’d discuss with your doctor of course about adding OTC or prescribed ESTRIOL.
You can also try non-hormonal suppositories for atrophy/dryness in addition to your HRT regimen.
You can also try non-hormonal suppositories for atrophy/dryness in addition to your HRT regimen.
I had TVT procedure when I had a partial hysterectomy. I am 51, eat WFPB, very minimal caffeine occasionally, exercise at least every other day, have a BMI of 20 and still struggle with urgency. Would vaginal estrogen possibly help?
LISA , what type of diet do you follow?
Hello Dr. I understand that all women are different in terms of menopause and perimenopause. I’ve never had a full term birth, are you seeing anything different with women like me who are in perim/menopause?
Good question . I haven’t given birth either and in Peri and almost 46
Thank you so much for this! My family physician told me I need to use progesterone if using vagifem more than twice a week. I asked for a consult to a gynecologist. She says I don't need progesterone and has increased me to daily use. I am getting mild cramping. Doesn't that mean it is getting into my system? I'm concerned and confused.
Im getting cramping too. Using vaginal estrogen . I’m going to ease back from using it daily . I just started
You only need to use progesterone if you are taking systemic estrogen and have a uterus. Vaginal estrogen is not systemic and does not require progesterone. The vaginal cramping could be your vaginal wall thickening or you could be sensitive to estrogen. Dr. Hirsch has another video you may be interested in called "Why to take progesterone at menopause"
I am a onset menopause breast cancer patient with NED after bilateral mastectomy. My oncologist will allow my gynecologist to give me estriol + testosterone so long as my bloodwork shows estradiol 36 or lower. We keep tweaking the Rx because it once was 140, then 41 on 2 doses a week. I insert it vaginally. Is that the wrong way to use it? Also how do we explain the increase in estradiol if it is not systemic? Thank you in advance
Good question
I followed your advice. I have a history of breast cancer. I use estradiol 3 times a week. Why do I get really bad breast tenderness?
Thats a symptom of to much estrogen
I am currently on Exemestane due to DCIS breast cancer. Do you have any suggestion for painful intercourse that doesn’t contain estrogen? I have had 2 Mona Lisa treatments without success.
Research the options below, I am going to ask my medical and integrative team about them as well, I am at the end of bc treatmemt and in a similar situation as you:
IntraRosaa
Sea Buck Thorn Sibu oil
Foria arousal and Awaken CBD Oil
Hyaluronic Acid
Vit E suppositories
Carlson Labs Key E Suppositories
Vaginal DHEA
I was thinking about the Mona Lisa procedure but the reviews just dont seem worth it, perhaps it does help to an extent with overall vag tissue health but not painful intercourse
I'm going through menopause and have noticed a lot of changes in my vaginal area, as well as experiencing frequent urination and urgency as well as burning, itching and dryness in my vagina. My OB-GYN prescribed Premarin cream fir me to use, but I don't like having to use the applicator as the cream doesn't always stay inside my vagina after insertion. The nurse recommended using my finger to apply it, but I'm not to fond of doing that. Is there some other form of medication that I can use to treat these symptoms or another brand?
Vagifem has no mess at all, it's like a tiny pill that you insert using an applicator. Dr. Hirsh mentions Imvxxy that apparently doesn't have mess either.
What you recommend for breast cancer patients for vaginal dryness
but the box warns your abour cancer with cream. its right on the box in bold. letters. it a new box in my draw.
I’ve been using generic estradiol vaginal cream .01% with good effect. I just found out that one of the inactive ingredients in the cream is hypromellose, which I beed to avoid. Can a weak strength compounded (to avoid this ingredient) estradiol cream be used in the vagina and remain locally in the vagina?
Who thought I would be free from hirsutism Dr iyaremoses on TH-cam did help me get rid of hyperthyroidism with herbs medications.
With the coconut oil in the one product , could it cause you to have a yeast infection?
Who thought I would be free from hirsutism Dr iyaremoses on TH-cam did help me get rid of hyperthyroidism with herbs medications.
Thank you for your information. I have tried to use estrogens prescribed by my doctor but every time I use it, it turns my vaginal skin very sensitive, painful and swollen. What to do at that point.
Who thought I would be free from hirsutism Dr iyaremoses on TH-cam did help me get rid of hyperthyroidism with herbs medications.
Can you comment on Mona Lisa Touch vaginal treatment. It seems like a scam, but would love to hear your opinion.
(Asking for my wife) Can you use the ring if you’ve had a hysterectomy? Thanks
Yes you sure can!
About 10 years ago I had a blood clot in my leg so my Gp doesn't want me to use estrogen my uro says it will help with UTI's probably I had a hysterectomy when I was 31 I'm 63 now. Its a scary dilemma for me what is your opionion on using estrogen I have used vaga-fem a few years ago. Thanks.
What caused you to stop the Vagifem? 🤔
@@karintatum7424 my GP who was my blood clot Dr. Also,doesnt want me to take any estrogen , estrogen can cause blood clots and once you have a clot you are prone to getting another. He did leave up to me but I havent took any estrogen since . Clots can kill you very fast. If i get another clot I'd be on warfarin the rest of my life so hard desisions. Even though they say topical estrgen goes very little system wide.. But my Dr. Says but if your that one so? Its all hard.
Vagifem, or any local vaginal estrogen for GSM, is absolutely fine and does not increase the risk of blood clot, so you are OKAY to use it and IT WOULD HELP!
@@heatherhirschMD yes I agree my Md just has huge doubts. Its hard.
I have been pronouncing Estring “est” ring, rhymes with best ring. I am a pharmacist. Am I pronouncing it wrong?
funny You caught that! Keep calling it what you are I think I have my own way of saying it so I make sure I differentiate it from the femring and Estrace cream
I am factor 5 and can’t take any estrogen. Help!!
You can use vaginal E
I still not sure about vaginal estriol not being absorbed systematically.
When you are prescribed transdermal estradiol your serum level goes up, so it is absorbed through the skin.
The vagina has lots of nerve ending and little veins so i am sure that it also goes systematic.
If as a postmenopausal women i would test before and after using estriol cream that would give me definet answer may be.
When i use vaginal estriol my hot flashes are less, go figure it out!
Are they safe if you've already had endometrial stage 1 and hyserectomy? OBYN ONC saying no it's like fire on gasoline.
Ask about imvexxy 4 ug ultra low but you need something!
@@heatherhirschMD Awesome thank you I have my 1-1/2 year check up next week with Gyn Onc..will do.
PS Love your videos very informative !!! ;)
Who thought I would be free from hirsutism Dr iyaremoses on TH-cam did help me get rid of hyperthyroidism with herbs medications.
I was facing hirsutism, I suffered until I meet Dr iyaremoses on TH-cam, who cured me from it for more information you can reach him out on TH-cam..
Please don’t use Premarin. Research it. It’s a very cruel industry
Couldn’t agree more. I can’t believe it’s still legal to do what they do to these poor horses! People don’t think about it, and what about the foals too? Most are shipped out to auction to slaughter. Horrible horrible horrible!
Are there any good alternatives?
It said it could cause cancer of the womb
INTRAROSA ???