What if I told you there was a treatment that could help improve your sex life
prevent recurrent UTIs and even help your urinary symptoms? Well, I'm Dr. Rena Malik,
urologist and pelvic surgeon, and today I'm going to let you in on a secret that everyone
should know about. We are so so close to one million subscribers, thank you so so much to
each and every one of you who've subscribed so far please share this channel with your friends
have them subscribe so that we can get to that one million mark I would really appreciate it!
So this magical treatment is actually for post-menopausal women but before you click away
each and every single one of you knows someone in this category a mother a wife a sister
a partner or a friend I guarantee you that these women will love you if you share this information
with them so stick around learn about it and share this video with them so that they can help
themselves too so before we get into this magical treatment I need to explain what happens to the
vagina after you lose estrogen during menopause so prior to menopause we have lots and lots of
circulating estrogen and they help with three main things number one is thickness and elasticity they
increase the collagen content of the vagina to help it be soft and pliable number two they help
with moisture it helps maintain things like muco polysaccharides and hyaluronic acid which helps
the vagina have moisture and lastly it helps with maintaining good blood flow but even more than
that the vagina produces something called glycogen when estrogen is around and lactobacilli which are
good bacteria in the vagina use this glycogen to produce lactic acid this keeps the vagina
an acidic ph between 3.5 and 5. and this helps maintain normal vaginal flora and protects women
from recurrent urinary tract infections and vaginal infections this is why so many women start
getting recurrent utis right about the time when they're perimenopausal are about to go through
menopause once you go through menopause the normal circulating estrogen declines 95 percent
to a level of five picograms per milliliter when a normal pre-menopausal woman has anywhere between
50 to 350 picograms per milliliter depending on the stage of menstruation their body is in
so once you lose that estrogen what happens well the vaginal epithelium or the skin of the vagina
thins it loses elasticity the vaginal canal itself shortens and narrows and your secretions
decrease by almost half and lastly the vaginal ph increases to above five so you lose that
lactic acid which helps prevent those bad infections outside of menopause there are
other states that women can have decreased estrogen one is if they've had their ovaries
removed surgically number two is if their ovaries are not functioning correctly or potentially if
they've had radiation or chemotherapy that can affect the function of the ovary number three
is if they're taking medications that can have anti-estrogenic effects like those that are for
breast cancer like tamoxifen also interestingly women who are lactating just after having a baby
postpartum can have decreased estrogen states and lastly if you have disorders of the hypothalamus
or the pituitary or other conditions like lupus that can affect that you can potentially affect
your estrogen production so what symptoms are you really going to have well you could have
vaginal dryness decreased lubrication decreased arousal orgasm or sexual desire you can have pain
with intercourse as well as malodorous vaginal discharge you can even have vaginal bleeding due
to the friction from sex when you have really thinned out vaginal epithelium and lastly you
can have urinary symptoms like urinary frequency pain with urination discomfort and burning and
recurrent urinary tract infections and you know the kicker is that 70 of women with these problems
don't even talk to their health care provider about it because they think it's just normal
and they have to live with it well guess what there are treatments that help so what can you do
well first off you can try things called vaginal moisturizers they can certainly help with the
dryness and discomfort and potentially with any of the symptoms that are associated with that
dryness and discomfort but it hasn't been shown to help prevent recurrent bladder infections
lubricants are a great option particularly if you're having pain with intercourse i've made
a whole video about lubricants but typically i recommend if you're not sensitive to silicones
or oil-based lubricants those are a little bit better because they last a little bit longer
whereas the water-based lubricants need to be reapplied because they do dry up pretty quickly
if you have symptoms despite trying all these things another option is vaginal estrogen and a
lot of people get freaked out when i talk about vaginal estrogen but estrogen works great and
using vaginal estrogen doesn't increase the amount of estrogen in your body to a significant amount
it increases it only slightly very minimally increase compared to pre-menopausal levels there's
actually never been a reported case of breast cancer blood clot or any other problematic disease
process due to the vaginal form of estrogen this is different from taking a pill by mouth
but putting it in the vagina will actually help with all of these symptoms specifically recurrent
urinary tract infections and even urinary symptoms like urgency and frequency they're super easy they
come in multiple different formulations including a cream a suppository or tablet that you can put
in the vagina or a ring that your healthcare provider can place and you can have change once
every three months there are some minimal side effects sometimes people get vaginal discharge
breast tenderness or vaginal bleeding however i prescribe this on a regular basis and i can
remember one patient in the last three years that's had any issues with the vaginal estrogen
after you started it takes about six weeks to see the full effect so stick with it the only
real contraindication is patients who are actively being treated for breast cancer if you've had a
history of breast cancer talk to your oncologist because this may still be an option for you
however if you're completely averse to estrogen treatment there are other options available there
is vaginal dhea as well as aspenifein which is an oral medication and lastly off-label testosterone
if you want to learn more about those comment down below i'll make a video about them but
make sure you talk to your healthcare provider if you're suffering with any of these symptoms
as always remember to take care of yourself because you are worth it