How It Is Given
Getting Started
Most Common
Vaginal health
Almost every other menopause symptom eventually eases on its own. This one does not, because it is caused by progressive tissue change rather than by fluctuation, and it worsens steadily without treatment. Treated routinely at our Las Vegas clinic.
Why it is different
Unlike flashes, this one does not come and go, which is why the Las Vegas approach treats it as a tissue change rather than a fluctuation. The tissue of the vagina, vulva and urethra is rich in estrogen receptors. As estrogen falls, that tissue becomes thinner, less elastic and less well supplied with blood, and natural lubrication drops.
Because the cause is a structural change rather than a hormonal swing, it does not resolve when the transition finishes. Left alone it progresses, and it affects a majority of postmenopausal women to some degree.
The symptoms extend beyond dryness: irritation, burning, discomfort during sex, urinary urgency and recurrent urinary tract infections all trace back to the same tissue change. More on that in brain fog and memory, low energy and fatigue and low libido. Recurrent urinary infections are easy to attribute to something else, so mention them at a Las Vegas appointment even if dryness is what brought you in.
Treating it
Cream, tablet or ring. Daily for two weeks, then twice weekly. It resolves symptoms for the large majority of women.
Tissue has to rebuild. Judging this at six weeks underestimates what it will do.
A vaginal moisturiser used regularly helps between doses. Lubricant helps during sex. Neither reverses the tissue change.
Stopping usually means symptoms return within a few months, because the underlying change resumes.
Why it goes untreated
Among menopause symptoms, this is the one most likely to go unmentioned in a Las Vegas appointment and among the most straightforward to treat. Surveys consistently find that a minority of affected women raise it with a clinician, and that many assume it is an inevitable part of aging. It is not, and the treatment is straightforward.
It is also the symptom least likely to be volunteered, so we ask directly. If you would rather not discuss it out loud, writing it on the intake form is entirely fine and gets the same result. The detail sits in fsh and estradiol testing, dosing and adjusting and stopping hrt. You will not have to raise it unprompted in Las Vegas, and the intake form works just as well as saying it out loud.
Other symptoms
Most women have several of these at once. They share a cause, which is why they often shift together.
Common questions
Treatment, safety, how long to continue, and what to do after breast cancer.
Patient reviews
I had been waking three or four times a night for two years and had been told it was just stress. The consultation actually went through my cycle history. Six weeks on a patch and I am sleeping through.
What I wanted was someone who would talk about the risks honestly rather than sell me something. They walked through the clot data and why a patch suited me better than tablets.
The brain fog was the part nobody warned me about. Having a clinician tell me it was a recognized symptom and not early dementia was worth the appointment on its own.
It took two dose changes before things settled, which they had told me upfront might happen. The three-month review was booked before I left the first appointment.
From the blog
Next step
This is the symptom most women do not raise and the one most likely to worsen if they do not. Writing it on the form is enough to get it dealt with.
Consultations are by appointment. Prescriptions are issued only where clinically appropriate.