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6 Signs You May Need Vaginal Estrogen 

There are common vaginal symptoms that are associated with low estrogen states. Even though estrogen loss is most common during the perimenopause and menopause phases of life, I am going to discuss symptoms associated with estrogen loss regardless of age. 

These symptoms can be common in some of the following circumstances:

1. Vaginal Dryness

Low estrogen levels can cause the vaginal tissues to become thin, dry, and less elastic. If experiencing persistent dryness, an evaluation and discussion with a healthcare provider is warranted.

2. Painful Intercourse

Dyspareunia, or painful intercourse, is another common issue related to low estrogen levels. Pain is usually the result of decreased lubrication, decreased elasticity, and thinning tissue that may bleed with minimal friction.

3. Frequent Urinary Tract Infections

Estrogen helps maintain the health of the urinary tract in addition to vaginal tissue. A decrease in estrogen can lead to a higher risk of urinary tract infections. This is mainly caused by: 

low estrogen→ a shift in the vaginal pH→ suitable environment for more UTI-causing bacteria

4. Vaginal Itching or Burning

Chronic or persistent vaginal itching and/or burning can also be a sign of low estrogen levels. This discomfort results from thinning vaginal tissues and changes in local bacteria.

5. Changes In Vaginal Discharge

This may show up as a change in baseline discharge consistency, color, and sometimes odor.  Since these symptoms may show up in other disease states, it is important to speak with a healthcare professional if/when any of these changes occur.

6. Pelvic Discomfort

Pelvic discomfort can present at baseline or with triggering activity.  When pelvic pain is associated with low estrogen levels, it may present with and after penetrative vaginal activity.  Pain may be acute or chronic.  Like pain with intercourse, it is likely associated with decreased vaginal elasticity and lubrication. Women with recurrent or complicated UTIs associated with estrogen loss may also experience pelvic pain.

Consulting Your Healthcare Provider

If you're experiencing any of these symptoms, it's crucial to talk to your healthcare provider. They can help determine if vaginal estrogen is the right option for you and guide you through the appropriate treatment.

Hot Topics in Women’s Health

An interesting read about women’s healthcare: 

The United States is experiencing a growing OB-GYN shortage. Here’s why. – The Hill

Soul-Full ‘Scripts

The 3P Formula

How often do you consider how your thoughts impact your overall well-being? The ways I looked at my health and wellbeing, and even how I approached changes in my profession have been impacted by a formula I call the 3Ps.  After being introduced to “The 7-Day Mental Diet” By Emmet Fox in 2019, I could never look/feel/assign beliefs the way I did in the past.  The potency, persistence, and passivity formula was inspired by this book.

I took control of many of my thoughts as if they were an investment in my life.  Now each time I take inventory of my thoughts, and am faced with making decisions and how they serve the life I desire I approach them with the following formula: 

Potency: How important and impactful is the thought?  Ie does it align with feelings of fear, anger, sadness, etc?  Will the potency of this thought serve me favorably?

Persistent: Does the frequency of the thought inspire or cripple me in any way?  Does it drive decisions or inspire me to take action? If so, will it improve my life?  Do the thoughts stall my growth in any way?

Passivity: Where did this thought come from? Was it passed on to me in childhood? Was it born from a fearful or joyous experience? Since the majority of our ~70,000 thoughts a day run on autopilot, how can I reset the thoughts that are keeping me stuck or no longer serving me?

By implementing these internal shifts in my thinking, I have been able to see my external circumstances differently.  I have been able to use this as a proactive approach to life happening through and not to me. I am more present, more mindful, and confident in how I show up in my personal and professional life. 

If the above formula resonates with you, I encourage you to try it.  I would love to hear about your experience and results after implementing the 3P formula in the comment section down below.

Let’s Get Clinical: Ask Dr. Johnson a wellness question

Here I answer real questions that I have been asked by patients, family members, and strangers (once they find out I am a doctor). I try to answer these questions in a relatable and educational way as I believe if one person has this question so do many others :) 

At 70 years old, my periods started again. Is this normal?

This is not normal. There is no “restarting” of the period after menopause!

This is known as postmenopausal bleeding. If this has happened, seek medical care right away as this is cancer until proven otherwise. Specific testing will be completed by your provider for further evaluation. 

Family history will also be important during this evaluation.  So, if able to get updated on the cancer history of your family while planning to see your care team you can answer these inquiries a bit more confidently. 

Your personal gynecologic, obstetric, and social history will also be important in a postmenopausal bleeding evaluation.  In addition to being prepared to spend a significant amount of time on the details of your symptoms and health history, be prepared to have a pelvic exam.  

This can be a lot to comprehend, so consider bringing someone for support and for another set of ears.  Ask many questions and take notes.  Leave the visit with an understanding of what follow-up plans and result communication are expected.

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