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 Many women have been reluctant to use HRT to ease menopause symptoms
since 2002, when the federally-funded Women’s Health Initiative (WHI)
study linked the treatments containing man-made versions of the
female hormones estrogen and progestin to an increased risk of
breast cancer, heart attacks and strokes.
For the current study, researchers compared how well locally-applied
estrogens helped relieve vaginal pain and dryness among women who
stopped HRT after the WHI results came out, as well as among women
who stayed on HRT or resumed treatment after a temporary halt.
Women were most likely to use the vaginal estrogen if they reported
pain during sex, and if they had stopped HRT, the study found.
Among the women who abandoned HRT and never went back, the
participants using vaginal estrogen reported significantly higher
satisfaction with their sex lives, the study published in Menopause
also found.
“We would expect that the women with the most severe symptoms would
show the greatest benefit and the group that stopped
estrogen/hormone use after the WHI would be expected to develop
symptoms and benefited the most,” senior study author Dr. Michelle
Warren, of Columbia University Medical Center and the Center for
Menopause, Hormonal Disorders and Women’s Health in New York, said
by email.
Women go through menopause when they stop menstruating, which
typically happens between ages 45 and 55. As the ovaries curb
production of the hormones estrogen and progesterone in the years
leading up to menopause and afterwards, women can experience
symptoms ranging from irregular periods and vaginal dryness to mood
swings and insomnia.
Vaginal dryness and painful intercourse are symptoms thought to
result from atrophy of vaginal tissues because of falling estrogen
levels. HRT has been shown to improve these symptoms by rebuilding
vaginal walls.
Before the WHI study raised concerns about HRT, millions of women
took Prempro, a pill combining progestin and estrogen, or Premarin,
an estrogen-only pill. Pfizer Inc. acquired Wyeth, the maker of
Premarin and Prempro, in 2009. Warren has served as a consultant to
Pfizer, but she said the study was designed and conducted without
input from the company.
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For the study, Warren and colleagues studied vaginal estrogen use
and sexual health in 310 women in New York City who were born
between 1938 and 1953 and had used HRT for at least five years.
While about 36 percent of women who stopped HRT used vaginal
estrogen, so did around 17 percent of women who continued HRT, the
study found.
Overall, roughly a quarter of women in the study used vaginal
estrogen.
The researchers acknowledge that the study is limited by its small
size and the fact that participants were generally healthy, highly
educated women with normal weight, so the results may not generalize
to other groups.
Even so, the findings suggest that some women may benefit from
vaginal estrogen whether or not they use HRT, the authors conclude.
“Vaginal estrogen is safer because very little if any estradiol gets
into the blood stream,” Dr. Michael Thomas, a researcher in
reproductive endocrinology and infertility at the University of
Cincinnati Medical Center, said by email.
Lubricants may help make sex less painful for women after menopause,
but this alternative can’t work like estrogen to improve the mucous
lining of the vagina and make bleeding and abrasions or tearing less
likely during intercourse, added Thomas, who wasn’t involved in the
study.
SOURCE: http://bit.ly/1Ng3Z4t Menopause, online August 8, 2015.
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