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Treating Menopause's Secret Symptom.

Don't Ignore Dryness

Some Treatment Options continued...

"Even women who have developed quite a lot of atrophy, or even narrowing or shortening of the vaginal canal ... can comfortably use this tablet because the applicator is so slender," says Kaunitz.

Inside the body, the pill dissolves slowly over a few days to release small amounts of estrogen. A new pill must be put into place about twice a week.

More recently, Pharmacia has begun marketing a product called Estring, which is a ring that is also inserted high into the vagina. It slowly releases estrogen over about three months, at which time the ring is removed and discarded and a new one is inserted.

Both Vagifem and Estring are easy to use and, once inserted, cannot be felt at all. They also do not fall out no matter how active you are. Although they increase the amount of estrogen in the vagina, blood levels of estrogen do not appear to go up. As a result, many physicians feel they are safe even for women with breast cancer.

Brown tried both and decided Vagifem is the best option for her.

"What I noticed immediately was that I had just normal lubrication," she says. "It felt natural. Even when I wasn't having sex, the whole vagina area just felt better, normal."

The Alternative Approach

There are some alternative remedies that appear to be helpful.

Luc Maes, ND, DC, is a chiropractor and specialist in naturopathic medicine in private practice in Santa Barbara, Calif.

The first thing he does with patients who have what looks like atrophic vaginitis is rule out infections or other conditions, such as diabetes. If the vagina is very irritated, he uses vaginal suppositories made with soothing calendula and vitamin A. Vitamin E oil, which can be obtained by cracking open a vitamin E capsule, can also be used directly in the vagina to increase lubrication and soothe the vaginal lining.

To increase the amount of estrogen in the vagina, Maes uses products based on plants that are high in substances called phytoestrogens, which act similarly to estrogen. These include creams used as well as supplements taken by mouth. He also recommends all women approaching menopause to maintain overall good health with proper diet and exercise.

Love also uses some alternative therapies. Like Maes, she recommends using vitamin E to soothe and lubricate the vagina. For some women, she also recommends taking supplements of black cohosh, which is high in phytoestrogens, in the form of a standardized product called Remifemin. She also suggests that women eat one to two items of food a day that contain soy protein, which also has some estrogen-like action in the body.

She does not recommend, however, taking isoflavone supplements. Isoflavones are believed to be the active ingredient in soy, but this is not yet clear, and it is also not certain whether taking high doses of this extract is either safe or effective.

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