Atrophy and the symptoms that come with it, pain with intercourse, dryness etc., are due to lack of estrogen in almost all cases. Some patients with severe dysfunction will have external pain, irritation and skin breakdown. This can be termed vulvodynia. Traditionally, multiple treatments have been utilized including the dramatic insertion of nerve stimulators to reduce pain. Other associated problems include urinary frequency, urgency, frequent bladder infection like symptoms (culture negative and positive), and “interstitial cystitis,” all of which again have been treated with various intensive treatments including nerve stimulators. All of these problems can be completely cured with aggressive local vaginal estrogen therapy. I takes higher doses than commercially available and a period of time often 6 months or more for the symptoms to be resolved. The article above, as most discussions of this problem, focuses on post menopausal patients, but we are seeing an epidemic of post menopausal Symptoms in young women often in their young twenties. There are many reasons for this problem but the common denominator is lower estrogen that over time results in these symptoms. Vaginal estradiol doses of 0.25 mg twice daily will resolve these symptoms and more that are present in young people, as well as the post menopausal group. Other symptoms include: memory deficit, anxiety, depression, mood problems, attention deficit, migraine headaches, acne, oily skin, scalp hair loss, bone loss, facial hair, weight gain, inability to lose weight, sleep disturbance, fatigue, low sex drive etc. etc. If you are suffering from any of these issues, it is very likely that low estrogen is part if not the entire problem. Unfortunately so many women are then prescribed medications to treat each individual symptom and the underlying cause remains untreated.
Michael D. Fox, MD
Advanced Reproductive Specialists
Jacksonville Center of Reproductive Medicine