SYNCPodcast_VaginalEstrogenSolo

Jenny Swisher: [00:00:00] Welcome friends to [00:01:00] this episode of The Sink Your Live podcast. Today we’re talking about something that is shockingly under-discussed. I can’t believe actually that we haven’t talked about it yet on this podcast. It’s deeply misunderstood, but it’s honestly life-changing for so many women, and that is.

Vaginal estrogen. Now, this is not hormone therapy in the way that you might be thinking. It’s not estrogen patches or gels. It’s not something to fear. In fact, I would really encourage you, even if you think to yourself at the, at the title of this podcast or the beginning of this podcast, that this doesn’t apply to you, I would encourage you to just hang on and listen.

Because maybe it is. Maybe there’s something here for you to learn. Now, before I go any further, please know that this is not medical advice. This is just me sharing information with you so that you can take it to your doctor. You can advocate for yourself in the best way possible so that you can reach maximum energy.

Now, I believe that vaginal estrogen is being way underused. I think this is something that is really gonna be on the rise now that we have the black box warnings off of things with estrogen. Now that. Sort of we’re , transitioning into this world of being welcoming and open to bioidentical hormone replacement therapy.

But [00:02:00] vaginal estrogen is different, and we’re gonna talk about those differences today. So that, again, so that you can take this to your doctor and maybe figure out if it’s best for you. So this is really, like I said, not something to fear. This is not traditional hormone therapy. It’s low dose, it’s local, it’s non-systemic therapy, and it can dramatically improve your quality of life, especially if you’re in perimenopause.

Menopause and yes, even if you’re a breast cancer survivor. So if you’ve ever experienced vaginal dryness. Sex pain, recurrent UTIs, burning, itching, bladder urgency, or if you felt like your vagina just doesn’t feel like it used to, well then this episode is for you. So let’s go ahead and get into it. So what happens in perimenopause and menopause?

Well, as our estrogen levels begin to fluctuate in perimenopause, and then of course they decline more permanently after menopause. One of the first places that the body feels it is in the vaginal canal and urinary tissue. Estrogen is not just about our periods in reproduction. It plays a critical role in so many things, including our vaginal [00:03:00] tissue.

We know that estrogen helps to keep our vaginal tissue thick, elastic, well lubricated, and well supplied with blood flow. So when estrogen declines, the tissue becomes thinner, sometimes drier, more fragile, more prone to irritation, tearing, infections, and pain.

So this sort of constellation of symptoms is now called the genital Urinary Syndrome of Menopause or GSM, but here’s the key point. This doesn’t get better on its own. Let me repeat that. It does not get better on its own. So unlike hot flashes, which may improve over time, vaginal and urinary symptoms often progress or worsen if untreated.

So many women are told that it’s just part of aging or just try using a lubricant or, well, I guess sex is supposed to hurt after menopause, but really none of that is true. So let’s talk about what vaginal estrogen is. Well, it’s low dose estrogen applied directly to the vaginal tissue. So it comes in several forms.

You can get it in a cream, you can get it in a, in a tablet, or a suppository, or sometimes even in [00:04:00] a soft vaginal ring. And here’s the most important thing to understand. Vaginal estrogen is local and non-systemic. That means that it works where it’s applied on the vaginal and urinary tissues with minimal absorption into the bloodstream.

So this makes it fundamentally different from estrogen patches, estrogen gels, estrogen pills. Those are all systemic hormone therapies. They’re designed to circulate through the body to treat symptoms like hot flashes, night sweats, mood changes, and bone loss. But vaginal, estrogen, vaginal estrogen is not intended for those symptoms and it doesn’t need to be.

It is simple and powerful. It can help restore vaginal tissue health. It can improve lubrication and elasticity. Reduce pain with sex, lower the risk of recurrent UTIs, and even improve bladder comfort and urgency, and it does this very effectively. The research on this is actually quite amazing. So there is a misconception that if something isn’t systemic, then it must be insignificant, but that is not true.

[00:05:00] Vaginal estrogen delivers estrogen exactly where the receptors are, which is in the vaginal and urethral tissue. Blood estrogen levels with low dose vaginal estrogen generally remain in the postmenopausal range, or rise only minimally and transiently. This is why major medical societies, including gynecologic and menopausal organizations, consider vaginal estrogen safe for long-term use.

For most women, unlike systemic estrogen, it doesn’t require progesterone and it does not stimulate the uterine lining at low doses. So this is really targeted therapy at its best. So I know the questions you’re coming up with, which is why I’m gonna try to address them here on the podcast. This is what I get asked the most.

Well, what about breast cancer survivors? Right? You’ve been told, you’ve been given the fear that you can’t handle estrogen. Right? And I’ve talked about this before on the podcast, that doing things like a Dutch test to see how your body metabolizes estrogen is pertinent for you. It’s pertinent for every woman.

It’s especially pertinent for you if you are a breast cancer survivor or if it runs in your family. But this is one of the most important and sensitive parts of this [00:06:00] conversation, right? Many women with a history of breast cancer are told, Nope, no estrogen ever full stop. You can’t have estrogen in any way.

But the reality is, it’s much more nuanced. Current evidence and expert guidelines indicate that low dose vaginal estrogen may be appropriate for many breast cancer survivors, particularly when symptoms are severe, when non-hormonal treatments have failed, and when quality of life is significantly affected.

This includes many women that have estrogen receptor positive breast cancer, and women who are on aromatase inhibitors or tamoxifen. So decisions should always be individualized, right? Health is individual, and they should always be shared between the patient, oncologist and clinician.

But here’s the key takeaway. Vaginal estrogen is not automatically off limits for breast cancer survivors, and for some women it can be the difference between chronic pain and comfort. Recurrent infections, avoiding intimacy, right? All of this stuff really matters. It matters for our quality of life. It’s not just about sex, right?

It’s not just about sex and, and when I’m talking about quality of [00:07:00] life, that’s not just what I mean. It’s also about being able to sit comfortably, exercising without irritation, sleeping without burning, or urgency, traveling without constant bathroom anxiety, right? Vaginal and urinary symptoms affect our confidence.

It affects our relationships, our mental health, and our overall sense of wellbeing. But yet women are often expected to tolerate this in silence. You don’t have to suffer. You’re not too old, and this is not a vanity issue. It’s really healthcare. So here’s what I want you to take away from today’s episode.

Vaginal estrogen is low dose, local and effective. It is not the same as systemic hormone therapy. It is considered safe for long-term use for most women, and it may be an option even if you’re a breast cancer survivor. When guided by the right medical team. If you’re experiencing symptoms, start the conversation.

Ask your doctor about vaginal estrogen. Asked about GSM. Advocate for your comfort, your health, and your quality of life, because sinking your life doesn’t mean pushing through the pain, right? It means listening to your body [00:08:00] and giving it what it needs and what it deserves. I hope this is helpful for you.

I can’t believe really that we’re this many episodes in, and we haven’t touched on vaginal estrogen as a topic in and of itself, but we finally have, here you go. So listen to this again. Maybe even take this to your doctor. Make sure by the way that you’re working with a hormone knowledgeable, what we call a menopause informed practitioner when it comes to things like hormone therapy, because otherwise you might just be told, Nope, estrogen is not for you.

That could mean that you’re talking to the wrong doctor. So make sure it’s the right doctor. Make sure you’re advocating for yourself so that you can live with that maximum energy. I hope this is helpful for you guys. Talk soon. Take care. Until next time. Okay. [00:09:00]