What are your recommendations for vaginal dryness? I had a prescription for estrogen, but it was too expensive. What are my other options?


Vaginal dryness is part of the overall syndrome called genitourinary syndrome of menopause. It can be treated with either:

  1. Local vaginal estrogen - Local estrogen treats the vagina and surrounding tissues only.
  2. Systemic estrogen - Systemic estrogen treats the vagina and will also treat hot flashes and night sweats, along with many other benefits.

Unfortunately, many local vaginal therapies may not be covered by your health insurance.

Local vaginal estrogen comes in many different formulations including:

  • Tablet
  • Rings
  • Creams

Two additional non-estrogen therapies include:

  1. Ospemifene - FDA approved for the treatment of vaginal dryness (or genitourinary syndrome of menopause). Ospemifene is classified as a selective estrogen receptor modulator (SERM), meaning that is acts like estrogen on certain tissues in the body, but it is not a hormone and is taken orally daily with door.
  2. Local vaginal DHEA - Not yet FDA approved, it is only offered as a compounded medication inserted vaginally. This may be less expensive than vaginal estrogen cream.

Additional things to think about include non-hormonal vaginal lubricants and moisturizers as well as frequent intercourse, which can help maintain vaginal tissue. Limited data has suggested that laser therapy may help with vaginal dryness, but this may be cost prohibitive. I recommend you talk to your doctor about finding a medication that works best for you.

All My Best,
Speaking of Women’s Health Nurse

November 8, 2015 at 10:12pm