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What medications does Interlude offer for GSM?
We primarily offer vaginal estradiol cream. The North American Menopause
Society states in 2020: "For bothersome genitourinary syndrome of menopause symptoms not relieved
with
over-the-counter therapies in women without indications for use of systemic hormone therapy,
low-dose
vaginal estrogen therapy or other therapies (eg, vaginal dehydroepiandrosterone)
are recommended."
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Does vaginal estradiol really work?
Absolutely yes. Vaginal estradiol is applied to the vulva and the vaginal
opening
and restores moisture, plumpness, and elasticity to the tissues that have atrophied due to lack of
estrogen.
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Is vaginal estradiol safe?
Unlike
oral forms of estrogen, vaginal estradiol is prescribed in low doses and is minimally absorbed in
the
bloodstream. It has not been shown to increase the risk of cancer, stroke, or clot and women's
health
advocates have been lobbying the FDA to remove these warnings from the boxed safety information.
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What are the benefits of a healthy vagina?
As developments in modern medicine continue to extend life expectancy
beyond
the menopausal years, caring for the vulva and vagina can help extend the life of tissue - and thus
extend your enjoyment of your moment in life. Maintaining a
healthy vulva and vagina decreases the risk of urinary tract infections, decreases bothersome
vaginal
dryness, decreases pain with sex, and reduces frequency and burning with urination.
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How long does it take to start feeling relief?
Results are typically experienced within six to eight weeks of treatment.
If
symptoms are not beginning to subside after six to eight weeks, talk to your Interlude clinician.
You
may
need
a dose increase or adjustment. Checkins and messaging are included with your treatment and we look
forward to helping you with any questions that come up.
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When should I start taking vaginal estradiol?
Women seeking medical therapy can start when symptoms are severe (usually
10
years post-menopause) or earlier. Keep in mind that some vulvar tissues can disappear entirely in
the
post-menopausal
years. The labia
minora, for example, can completely dissolve without estradiol. When this happens, the urethra
may be exposed to abrasion or bacteria. Vaginal estradiol can prevent this much like sunscreen
prevents
sun damage.
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How do you apply vaginal cream?
Vaginal estradiol cream is applied as directed by your Interlude
clinician
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usually once daily for two
weeks and then twice weekly. A plastic applicator comes with the medication, but women find that it
wastes medication and is uncomfortable to insert into the vagina - especially if irritation is
already
present. Ask your Interlude clinician to help create a routine that suits your needs - it may be
perfectly
fine and sometimes even preferable to apply instead with your fingers to the affected areas of your
vulva and vagina.
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I'm currently taking an HRT estradiol pill. Can I use estradiol
vaginal cream also?
Yes. Estradiol vaginal cream mainly acts locally and only a small amount goes systemic. Even if
there was
significant systemic absorption the combination would still be in range.
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How do I get a prescription for vaginal estradiol?
At Interlude we offer an online consultation with medical provider that's licensed in your state.
All
you
need
to do is take our online consultation. We'll pass your information along to a medical provider who
will
review your history and symptoms in detail and prescribe treatment if appropriate.
