If you’re bothered by vaginal dryness or itching or painful intercourse but not hot flashes during menopause, consider requesting a prescription for low-dose vaginal estrogen cream, tablet, ring, or suppository that you place in your vagina.
Because estrogen is delivered directly to the vaginal tissues, you may improve these symptoms but avoid some of the risks and side effects associated with oral and topical systemic hormone replacement therapy, also called menopausal hormonal therapy. Low-dose vaginal estrogen can counteract vaginal atrophy, which is often associated with discomfort while you’re sitting, exercising, and wearing tight clothing.
Research suggests that some types of vaginal estrogen can improve urinary incontinence, urgency and frequency, and lessen the incidence of urinary tract infections.
If you prefer taking an oral pill for vaginal dryness, the estrogen agonist/antagonist ospemifene (Osphena), available by prescription, can treat moderate to severe dyspareunia (painful sexual intercourse). Ospemifene’s side effects may include hot flashes, vaginal discharge, muscle spasms, and excessive sweating.