Frequently Asked Questions

The female hormone oestrogen, which is produced by the ovaries, helps to keep the vagina moist and maintain the thickness of the vaginal lining. After menopause, vaginal dryness and other symptoms that affect the vagina and the urinary tract may occur, because the ovaries produce less oestrogen.1,4,13 Luckily, these effects are reversible. The vagina responds quickly to oestrogen therapy to relieve the discomfort caused by vaginal dryness.1
No, unlike hot flushes which tend to go away after a while, vaginal symptoms do not go away on their own. In fact, they can get worse if not treated. The International Menopause Society recommends that it should be treated as early as possible, and treatment may continue for as long as bothersome symptoms persist and you have no contraindications.1
Yes! Up to 50 % of women will develop some vaginal symptoms in menopause. Since only 1 in 4 women ask for medical help, it is possible that the incidence may be even higher, as many women do not talk about their symptoms.1
Vaginal dryness can be helped by simple lubricants, but the best and most logical treatment for vaginal atrophy is to use local oestrogen.1 According to the International Menopause Society, local vaginal oestrogen therapy is preferred when symptoms are limited to the vagina. This is because only small doses of oestrogen are needed to treat vaginal symptoms of menopause, plus the vaginal response to local oestrogen therapy is quick and long-lasting. Local oestrogen therapy can be given as vaginal tablets or a vaginal cream.1
Local oestrogen therapy is administered directly into the vagina, and can be given as vaginal tablets or cream. Local oestrogen is preferred when symptoms of menopause are limited to the vaginal area.1,14 Systemic oestrogen therapy is preferred when women have other symptoms of menopause as well, such as hot flushes, and can be in tablet form, a patch or a gel. It is interesting to know that up to 25 % of women using systemic oestrogen therapy will still experience vaginal dryness. Local oestrogen therapy is sometimes given in combination with systemic oestrogen therapy.1,14
Lubricants are often used to alleviate vaginal dryness during sexual activity, but the effect is temporary. Lubricants also do not contain any oestrogen, and therefore do not address the cause of your symptoms. The vaginal response to local oestrogen therapy is quick and long-lasting.1,14
Speak to your doctor/pharmacist if you experience symptoms of vaginal dryness. This will help to determine if local vaginal oestrogen therapy is suitable to treat your symptoms. Vaginal oestrogen tablets can be obtained without a prescription from your pharmacist.6
No. Additional progestogen is not necessary if you use vaginal oestrogen at a low dose.1

It is important to tell your doctor if you experience any unexpected or abnormal vaginal bleeding.1
Local vaginal tablets are absorbed locally in the vaginal tissue where it is needed, and result in very low/minimised levels of oestrogen circulating in your blood stream, whereas oral tablets are broken down in your digestive system and liver, resulting in much higher circulating blood oestrogen levels.14,15

There are no guidelines at the moment that limit the length of time that you may use vaginal oestrogen. The International Menopause Society recommends that vaginal oestrogen be used for as long as bothersome symptoms persist, and that the dose of oestrogen should be low however there is currently limited data regarding use beyond 1 year.1


It is important to tell your doctor if you experience any unexpected or abnormal vaginal bleeding.1

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