Week 6 Web Exploration Videos.docx

There are three highly effective forms of low dose

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vaginal therapy is the next step. There are three highly effective forms of low dose vaginal estrogen. There is a tablet that is placed in the vagina twice weekly, creams that are placed in the vagina 2 or 3 times weekly and its very simple to use vaginal ring that is put in the vagina and left in for three months and releases a very low dose of estrogen over the three months. For women with an intact uterus, is a progestin even indicated? You do not need to use progestin when you are using very low dose of estrogen, essentially low-dose vaginal estrogen products will not bump a woman’s blood level of estradiol so there is no need for concurrent estrogen. Along these lines, every postmenopausal woman should be reminded to report any bleeding after menopause even if it is after sex. Because it hardly bumps the level or doesn’t bump it all, what about women with breast cancer those who are no longer on active treatment and those who are on aromatase inhibitors? For women who are not on aromatase inhibitor, majority of the women can safely use low doses of vaginal estrogen simply because the blood levels are not bumping. I typically do speak with a women’s oncologist and make sure the oncologist is also on board with treatment. Many oncologists are okay especially if women have tried other options and they’re
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still really distressed by changes in their sex life. The goal of aromatase inhibitors is to take the low levels of estrogen that are present in postmenopausal women and basically reduce them to almost unmeasurable. Although low-dose vaginal estrogens don’t bump estrogen blood levels above typical levels for menopausal women, there will be a small amount absorbed. For women on the aromatase inhibitor, it’s probably not a good idea. It is not contraindicated in women with a history of heart attack, hypertension, stroke, leg or lung clot. Overall, there are many women with symptoms of GSM who are not on therapy simply because healthcare providers are not asking. Every clinical should ask every postmenopausal patient at every well comprehensive visit if they have any vaginal dryness or discomfort with sexual activity, or any concerns about sex life.
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  • Fall '15
  • Sexual intercourse, estrogen

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