Androgenic Solutions For Urogenic/vaginal Atrophy

bobbity

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The problem of urogenic and vulval atrophy in menopausal women is typically understood to be a consequence of estrogen deficiency in the respective tissues.

Urogenital atrophy. - PubMed - NCBI

"The major cause of urogenital atrophy in menopausal women is estrogen loss. The symptoms are usually progressive in nature and deteriorate with time from the menopausal transition. The most prevalent urogenital symptoms are vaginal dryness, vaginal irritation and itching. The classical changes in an atrophic vulva include loss of labial and vulvar fullness, with narrowing of the introitus and inflamed mucosal surfaces. Dyspareunia and vaginal bleeding from fragile atrophic skin are common problems."

As such the standard treatment is topical estrogen cream (estriol). One such case is described here (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174723/).

"A 39-year-old female patient was referred from the gynecology department with the complaints of burning and pain sensation during micturition for 3 months...The patient's obstetric history was uneventful. Routine hematological and biochemical investigations were normal. The patient was advised topical estrogen cream for 4 weeks and the lesion resolved completely in 4 weeks".

Prasterone's approval for vulvar and vaginal atrophy is a promising line of treatment.(FDA Approved First Drug Containing DHEA)

Predictably, Prasterone is is understood to exert its therapeutic effects by way of its estrogenicity ( o_O). Assuming that the androgenic effects of DHEA/Prasterone are significant in terms of its effectiveness...I wonder if the members of this forum might have any thoughts about more explicitly androgenic solutions to this issue? Equally I wonder if anyone had information regarding depletion of estrogen in those tissues as being therapeutic for these issues?

@haidut @Blossom
 
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Blossom

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Thanks for tagging me. I’m not sure where to begin and I’m not a scientist but unfortunately I have some experience with this issue.

I understand that estrogen application to the vaginal tissue helps a lot of women. It’s no secret that Peat is very anti estrogen. When a woman has these issues though the situation can become very desperate and interfere with quality of life to the point of disrupting the ability to do certain daily activities, some types of work and even have a satisfactory sex life. I don’t think many people want to wear adult diapers either if they can avoid it! Many factors will influence how a woman feels about this but I think if someone desires help then they should be able to try whatever hormones may work. I have read that topical vaginal estrogen isn’t absorbed systemically beyond the first few weeks once the vaginal tissue thickens with treatment but that’s a highly personal choice that each woman must make for herself.

I’ve not tried prasterone but I’ve used cortinon (dhea/progesterone) and estriol alternating them with good results. Weight loss and increasing physical fitness also helped me tremendously but weight loss would only help if someone was overweight or obese. I have resolved all my genitourinary issues with diet, weight management and the above hormones applied vaginally. Oxalates specifically gave me vulvodynia and interstitial cystitis which can be confused with menopausal changes. That certainly doesn’t apply to everyone either.

I’m willing to accept that tissue bound estrogen may be high in menopause but it doesn’t seem to be high in the vaginal tissue. On this issue I had to go with quality of life while the debate rages on.

I’m not sure if my personal experience helps any but hopefully haidut and others will chime in as well.
Edit- I initially wrote pansterone which I also used but cortinon worked better for me.
 
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bobbity

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Thank you very much for your reply @Blossom - I was investigating this issue on behalf of a relative who is suffering with this. Topical estrogen, epsom salt sitz baths and oral cortinon seems to have done the trick for the meantime. The estrogen was suggested by the gynaecologist, it would have been interesting to see whether topical progesterone/dhea alone would have resolved the issue...the patient was unwilling to experiment and wait for results!!
 

Blossom

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Thank you very much for your reply @Blossom - I was investigating this issue on behalf of a relative who is suffering with this. Topical estrogen, epsom salt sitz baths and oral cortinon seems to have done the trick for the meantime. The estrogen was suggested by the gynaecologist, it would have been interesting to see whether topical progesterone/dhea alone would have resolved the issue...the patient was unwilling to experiment and wait for results!!
I’m happy for you/her. Cortinon alone worked for me at first but then the results waned a bit. Perhaps it has to do with where one is at in their menopause transition. Best wishes to you both.
 

GreenTrails

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I would also like to know if the progesterone and DHEA are used vaginally.
Also, where to you get Cortinon? Thank you.
 

Happycat

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In my experience, progesterone alone does not help with issues down there, even applied locally.

I do believe DHEA will help, but if it helps by way of converting into estrogen, then why not try estrogen directly (estriol cream or pessaries)? Just thinking out loud..
 

Tansia

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In my experience, progesterone alone does not help with issues down there, even applied locally.

I do believe DHEA will help, but if it helps by way of converting into estrogen, then why not try estrogen directly (estriol cream or pessaries)? Just thinking out loud..
I think that DHEA is the one that helps but in small doses it will convert mainly to androgens I would thought.
 
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