Vaginal Moisturizers Vs. Estrogen
Experience dryness, burning, itchiness, or pain with seggs?
Vulvovaginal products can be a game-changer.
Vaginal moisturizers, vulva creams/salves, and topical estrogen are a quickly growing market to support huge gaps in women’s health. At this point, the question isn’t “why doesn’t this exist?” but rather
What’s the difference?
Is one better?
Which should I use?
Someone experiencing the following might benefit from a moisturizer or estrogen
Postpartum/Breastfeeding
Menopause
Cancer treatment
Gender Affirming Care
Diabetes
Certain medications such as anti-depressants, some forms of birth control, or anti-estrogen medications
Vaginal Moisturizer
Vaginal Moisturizers are products designed to help add moisture (water) to the vulva and vagina, mimicking the body’s natural secretions.
This increased moisture improves elasticity and reduces dryness.
Vaginal moisturizers can be found over the counter and does not need a prescription for use. They may include hydrating and healing ingredients such as hyaluronic acid.
These products differ from from lubricants, which are used during sex. Similar to the way someone follows a skin care routine, you’d follow a routine for vulvar/vaginal moisturizing.
It can be applied as a cream/gel, insertable tablet, or through an applicator 3-4x/week.
Examples of vaginal moisturizers:
Bonafide Revaree - a moisturizing suppository
Good Clean Love - moisturizer that can be applied with an applicator or your fingers
Ah Yes - gel moisturizer you apply with your fingers
Topical/Local Estrogen
Estrogen is a sex hormone that helps provide support to our vaginal tissue.
Low-dose estrogen can restore the top most layer of of vaginal tissue to increase elasticity and tissue integrity.
Using local/topical estrogen is a medication that requires a prescription by a physician. It can come in the form of cream, insertable tablet, or ring.
Frequency and duration of use will depend on medication.
Examples of topical estrogen medications:
Yuvafem (Vagifem®)
Medication comes in an applicator. Put it into your vagina every day at bedtime for 14 days. After 14 days, put it into your vagina 2 times a week at bedtime.
Estring®
Medication comes as a vaginal ring. Put the ring into your vagina and push it as far back as you can. You need to remove and replace the ring every 90 days.
Estrace®
Medication comes as a cream. You put the cream inside your vagina and around your vaginal opening 2 to 3 times a week. Your healthcare provider will teach you how to do this.
Research: Estrogen Vs. Moisturizers
A study (Mitchell, 2018) looked at a group of women in menopause.
Results showed effects of a prescribed estrogen and over the counter vaginal moisturizer are comparable. Authors suggest that most women can achieve greater than 50% reduction in symptom severity with regular, consistent use of a vaginal gel with lubricant properties and do not see added symptom improvement with vaginal estradiol.
Another study (Smith, 2022) looked at women with perineal injuries postpartum. This study showed that topical estrogen is safe and acceptable regardless of lactation practices and that it showed mild reduction in atrophy after a perineal injury.
The 2022 postpartum study didn't compare to the use of vaginal moisturizers though.
The Verdict on Estrogen Vs. Moisturizers
It depends.
In general, research in women’s health is not great. These studies showed that low dose topical estrogen is safe during lactation. Win!
It also seems that there are fairly comparable effects when looking at women who used estrogen and women who used over the counter vaginal moisturizers. Both types of products work to improve tissue moisture and elasticity.
Factors that may impact your choice may include your medical history, medications, personal preference on application form/use of hormones, as well as cost barriers, specific symptoms and individual needs.
It’s best to discuss the use of estrogen and moisturizer with your medical provider beforehand.
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References:
Mitchell CM, Reed SD, Diem S, Larson JC, Newton KM, Ensrud KE, LaCroix AZ, Caan B, Guthrie KA. Efficacy of Vaginal Estradiol or Vaginal Moisturizer vs Placebo for Treating Postmenopausal Vulvovaginal Symptoms: A Randomized Clinical Trial. JAMA Intern Med. 2018 May 1;178(5):681-690. doi: 10.1001/jamainternmed.2018.0116. PMID: 29554173; PMCID: PMC5885275.
Smith PE, McLaughlin EM, Pandya LK, Hade EM, Lynch CD, Hudson CO. A pilot randomized controlled trial of vaginal estrogen on postpartum atrophy, perineal pain, and sexual function. Int Urogynecol J. 2022 Dec;33(12):3383-3390. doi: 10.1007/s00192-022-05149-x. Epub 2022 Apr 20. PMID: 35441854; PMCID: PMC9020152..