Treatments For Postmenopausal Symptoms

If you are postmenopausal or approaching the menopause and would like to find out what your options may be in terms of potential treatments, please use the information below. This information can be used in conjunction with support from your GP or health professional to help you find the right course of treatment best suited to your individual needs; enabling you to manage your symptoms and improve your quality of life.

Please use these suggestions carefully and always speak to your GP or health professional, they can explain what may be causing your problem and how the different treatments may help you. They will also talk to you about any side effects, these are extra problems that can be caused by some forms of treatment. Together, you can decide which treatment is the most suitable.

Some options that may also help include:

• Avoidance of soaps to wash with (perhaps replacing with aqueous cream, available from most pharmacies).
• Local vaginal lubricants and re-moisturisers, especially for intercourse (available from doctor or pharmacist).
• Treatment of underlying skin problems with topical creams, often after guidance by a specialist and perhaps skin-biopsy.
• Treatment of altered vaginal flora with appropriate antibiotics (often after an examination). This is short-term and may be administered by mouth or sometimes directly into the vagina. This treatment may need to be repeated.
• Local oestrogen therapy. It is now well recognised that low doses of oestrogen therapy, delivered locally in the vagina, can be effective.

Vaginal dryness, soreness, burning, vulval irritation and chafing can all respond well to local oestrogen treatments. This can also help greatly with discomfort, pain during sex, correcting the vaginal pH and stopping the overgrowth of abnormal vaginal flora. Local low dose treatment with oestrogen has been found to have significant effect on the postmenopausal urogenital symptoms related to atrophy.

Oestrogen delivered locally can be in the form of:

• Vaginal tablets: inserted using a pre-loaded applicator. These are used every night for 2 weeks and then twice weekly, as advised.
• Creams: inserted, using an applicator, daily initially, then as advised. Vaginal silica ring: inserted for a 3-month period.
• Pessaries: inserted daily, (preferably in the evening) initially, then as advised.

These treatments are effective and acceptable and unlike conventional forms of HRT, the effects are local therefore the risks of systemic side effects and risks are reduced.

Management of urinary problems

The role of local oestrogen in the management of urinary problems is complex. Oestrogen replacement therapy has been shown to alleviate urgency, urgency incontinence, frequency, nocturia and dysuria.

Stress urinary incontinence would not appear to be helped by oestrogen alone, but it does seem to add to the action of other treatments currently used.

Pelvic floor muscle exercises can help keep your pelvic floor muscles in good shape and give you more control over your bladder. If you would like to find out more about pelvic floor exercises, please visit our downloads section.