Estriol vs Estradiol for Atrophy and UTI | PYHP 144

In this episode, we discuss a listener’s question. ‘Hannah’ has been dealing with vaginal
atrophy, frequent UTIs, low libido, and reduced elasticity in her skin. She has been to
her doctor for treatment that has not helped.
We breakdown Hannah’s question into:
– Can vaginal atrophy be reversed?
– Menopause and libido
– Vaginal microbiome
– Menopause and UTI
– Estriol vs conventional treatment for vaginal atrophy
– Genitourinary syndrome of menopause

Hannah’s Question:
Hi Dr. Maki and Dr. Davidson. I am told to keep using my Premarin cream. I was initially
on estradiol 0.01% and changed to Premarin. I do not want to take Prempro. I have
used it for years with no improvement of my atrophic vaginitis and dysuria. I continue to
get UTIs. And, as an OR nurse, I cannot drink water in the operating room, it is a risk to
sterility. So I become water deficient, and I get urgency and I cannot leave the OR in the
middle of case. Sometimes a case can go 5 hours or more. Further, I am a 52 year
woman and post menopause. I became menopausal in 2015. The skin on my face and
neck are sagging — making wrinkles more pronounced. My vulva has become looser
and sagging. I cannot perform sexually because I cannot get aroused using clitoral
stimulation because it is so dry there. Lube does not help. I am very frustrated by this,
as is my husband. I get anxious as well because my mind is constantly worried about
my atrophy and vulvitis. Going to a specialist— they are very conservative in treatment.
My husband doesn’t understand. He continues to ask and I say my vagina is broken.
Can you please help me
If you have a question, please visit our website and click Ask the Doctor a question.

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