Vaginal Estrogen: Benefits and How to Prescribe

This video is made in collaboration with Dr. Alexandra Dubinskaya, who is a urogyn fellow.
I am a current OBGYN resident. The goal of the video is to help other residents understand the options for vaginal estrogen and the different dosages for both loading and maintenance that are common for patients.
Her website can be found here (current): drurogyn.com/
Vaginal estrogen is a type of hormone replacement therapy (HRT) that is used to relieve symptoms associated with menopause, particularly those related to vaginal dryness, itching, burning, and painful intercourse. It is also used to prevent or treat conditions such as vaginal atrophy (thinning of the vaginal walls), urinary incontinence, and recurrent urinary tract infections. Here are some of the benefits of vaginal estrogen:
Relieves vaginal dryness: As women approach menopause, their bodies produce less estrogen, which can cause the vaginal tissues to become dry and thin. Vaginal estrogen helps to restore moisture and elasticity to the vaginal tissues, reducing dryness and discomfort.
Reduces painful intercourse: Vaginal dryness can also cause pain or discomfort during sexual intercourse. Vaginal estrogen can reduce or eliminate this pain, making sex more comfortable and enjoyable.
Prevents or treats urinary incontinence: The loss of estrogen during menopause can weaken the pelvic floor muscles, which can lead to urinary incontinence. Vaginal estrogen can strengthen these muscles and reduce the risk of incontinence.
Reduces the risk of urinary tract infections: Vaginal estrogen can help to maintain a healthy balance of bacteria in the vagina, reducing the risk of bacterial infections such as urinary tract infections.
Improves quality of life: Many women experience a significant improvement in their overall quality of life after starting vaginal estrogen therapy. They report feeling more comfortable, confident, and sexually active.
It is important to note that like all medications, vaginal estrogen has potential risks and side effects. Women should talk to their healthcare provider about the risks and benefits of this therapy, as well as any other treatment options that may be appropriate for their individual needs.