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    Treating Menopause's Secret Symptom.

    Don't Ignore Dryness

    Some Treatment Options continued...

    Unfortunately, these lubricants, while helpful, are often not a complete solution for women with atrophic vaginitis. There weren't enough for Caroline Scott Brown.

    "They were kind of messy," she says. "They did help, but they didn't totally solve the problem and then an hour later I was dry again. That's when I started researching [prescription] products and called my doctor."

    For decades, relief has been available in the form of prescription creams that contain estrogen. They are placed directly in the vagina and although effective, they can be messy, and the estrogen is absorbed into the bloodstream. This can be a problem for women taking hormone replacement therapy because they don't want to increase the amount of female hormones in the blood even more. It is an even bigger problem for women who have or have had diseases, such as breast cancer, that thrive in an estrogen-rich environment.

    Still, for women who don't mind a little extra estrogen in their systems, these creams are often effective. If you do choose this option, Love recommends you "use a little dab on your finger ... . Do that every day for about three weeks and then about three times a week after that."

    And don't use estrogen cream as a lubricant with a male partner because he can absorb it, too -- and chances are he won't like that.

    Recently, a company called Pharmacia has started manufacturing two new products for atrophic vaginitis that overcome some of the disadvantages of estrogen creams. One, called Vagifem, is a tiny pill, about the size of a baby aspirin, that is inserted high into the vagina with an applicator about the size of a pencil.

    "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.

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