Vaginal atrophy and painful intercourse: What helps?

May I ask a likely elementary question? I had a hysterectomy at 38 and was not offered any HRT of any kind. At age 64, I developed a sticky, sour smelling discharge and learned it was vaginal atrophy sloughing off dead cells. The GYN prescribed a 10mg estradiol suppositoryi insert twice a week. And after quite a while that seemed to resolve it. After a few years I stopped the HRT. but recently I had to resume. So apparently the condition doesn’t get fixed… just managed.

So here’s my stupid question- would moisturizer do just as well? I’m reading about many of you using non hormonal moisturizer and am wondering if that’s an option for me. I am somewhat worried about HRT forever.

I really wish the message these female Urologists are so passionate about could be more accessible. They seemed to say that the locally applied estrogen addresses the urinary issues that result from lack of estrogen. It was my understanding that it’s about more than moisturizing the tissue. I’ll need to research that more. I’m just learning about this.

And, that the local estrogen works to maintain that area, similar to when your own body produces it, so it’s a maintenance thing, not a cure, which you wouldn’t need but once. I don’t know if you are supposed to take HRT and local estrogen at the same time.

If I had known more about the local estrogen option earlier, I would have gotten it immediately upon menopause. I hope I’ve intervened in time so there isn’t any damage.

The Replense that I have tried is unscented. I haven’t gotten but one box (Has 6 individual applications.), because I didn’t see the need. After the Estradiol, everything seems plenty moist, but I guess it wouldn’t hurt. I was afraid being too moist might cause a yeast infection.

I suppose gynecologist are supposed to be experts on this, but I have seen several and they never informed me about menopause properly, options for treatment, expectations, etc. I never had any bad symptoms like hot flashes, night sweats, etc. And, I recently took my mom to see one and it was a big disappointment. I won’t go into it here. But, the urologists on you tube seem to be the ones advocating for women and their pelvic health.

I guess I’m super charged about this issue, because almost every woman I know who has gone through menopause has urinary issues! Usually, prolapse, incontinence, weak bladder, urgency, frequency, etc. I am shocked that I don’t! I’m not sure why. This is an issue that needs attention. Thank goodness for this site!

@pb50. Pam, I figure it could be worth a try. Estradiol, by the way, isn’t considered HRT. The estrogen is “unopposed” by progesterone which could be considered a contraindication however the gynecologists I have talked with tell me that very little estrogen is absorbed by the blood stream since Estradiol is applied transdermally (to the skin). It’s a good question to ask the provider who prescribed your Estradiol. Still, why not try a non-estrogen product and see if you like the results.

Coming back to say thanks Helen - it’s stunning how uninformed I am about hormones

@marjou I posted the link to Hyalo Gyn for a non-estrogen vaginal moisturizer above these posts. Another option is Good Clean Love. You can order online or go to a Target store as they carry this brand.

Good Clean Love
— https://goodcleanlove.com/

Both of the above products are paraben-free and contain hyaluronic acid which is recommended by medical providers as a good vaginal moisuritizer.

@pb50. Pam, so are we all uninformed about hormones. This includes many of the primary care doctors I have seen locally. They place Estradiol in the same category as HRT and I only learned differently after talking with gynecologists, and the medical staff at Mayo in the Women’s Menopause and Sexual Health Department. It’s really terrible how we suffer as women because of some poor advice.

I don’t have material urinary issues - just old lady “give me a minute” syndrome 🙄

Did you see a physical therapist for the training? I’m not sure if I need the therapy, but would like an evaluation. Maybe, I’ll try the intercourse to see how it goes.

So glad you had good results with that therapy! My mom has had 2 surgeries for prolapse years ago. I have done kegel exercises before. I became concerned that I might be hypotonic, since I’m such an anxious person and discontinued them. Perhaps, I’ll resume them.