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Hi there KDC, Thanks for your question ... We asked Dr. Philip Sarrel, one of the leading sexual health experts in the country to respond to your post. Here is his thoughtful answer.

"It’s interesting that your age is 57 as that is the particular age for which specific data about vaginal atrophy is available in several studies. Vaginal atrophy means the shrinkage of vaginal and vulva tissue and a loss of cell function. Shrinkage of the tissue narrows the vaginal opening making penetration painful. Thinning of the vaginal walls and the external genitals (the vulva) makes these tissues vulnerable to tearing and infection. The decrease in cellular function leads to dryness of the vulva and vagina.
By age 57, it is estimated that 2/3 of women experience vaginal and vulva dryness secondary to atrophy. Pain with intercourse is the most common complaint affecting about half the women who are sexually active at your age.

Vaginal atrophy due to menopause is prevented by the use of estrogen and can also be reversed in women who have not used estrogen since their menopause occurred. All types of estrogen treatment are approved for prevention and treatment of vaginal atrophy including the estrogen ring that you mention. The estrogen ring provides a very small amount of estrogen which works locally on the vaginal tissues. The ring is easy to insert and is changed for a new one every three months. The ring has been available for about 15 years. Because the estrogen ring shows a good tissue effect with a minimal amount of estrogen and the lowest blood levels of estrogen of any of the postmenopause hormone treatments, it is suggested that it is hypothetically the safest to use for women at high risk for breast cancer or even for women who have had breast cancer. However, there are no published studies of the estrogen ring vs. other treatments vs. placebo with respect to breast cancer risk.

There are between 50 and 100 major, published studies of estrogen not combined with other hormones such as progesterone and the risk of developing breast cancer. Some show increased risk while others show either no increase or a decreased risk when using just estrogen. For example, one of the studies shows that using relatively high doses of systemic (oral) estrogen for more than 15 years increased breast cancer risk. On the other hand, the most important study in the United States, the Women’s Health Initiative, did not show an increased breast cancer risk in the women who just received estrogen for seven years compared to the women who received a placebo treatment. There are many informed physicians who would tell you that it would be an option for you to take a low-dose, systemic estrogen (and I am one of them). But, you seem to have thought about this and have a preference for the estrogen ring and I certainly can support that decision."

February 3, 2009 - 2:24pm

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