Free Women's Health Advice

Please know that our general columns cannot take the place of a visit to a qualified professional who can determine your exact situation and needs.

Archived Questions and Answers from
Debra L. Hill-Busselle, MD
On Women's Health Issues

• I am past childbearing age, do I need an OBGYN or can a Family Practice Physician do my Pap smear?

• I am 67 years old and have gone off my HRT. It seems I have less sensation with sex and that my vagina does not seem as firm with intercourse. Is this from stopping my estrogen?

• I am 16 years old and have a problem. Sometimes I notice an abnormal discharge. It looks like raw egg white. It does not have an odor. It goes away for a while, and then comes back again. What is wrong with me? I am afraid to ask my mom.

• I’m 58 years old and haven’t had a period for 5 years. I have a few hot flashes, but they are mild. I’ve never taken hormone therapy and seem to be doing fine without it. Sex, however, has become uncomfortable and at times it really hurts. Is this normal for someone my age?

• I’ve been having hot flashes and night sweats. My cycles are changing, I don’t sleep as well as I used to and I can be pretty moody at times. I am 46 years old and think I am too young to be in menopause. My friend, who is 39 years old, just stopped taking birth control pills three months ago. She is having hot flashes daily and has not had a period yet. She told me her mom went through menopause in her early 40s. Is she in menopause? Am I?

• I am 43 years old and try to exercise regularly. When I go to my aerobics class and we do jumping jacks, I leak urine! I am so embarrassed! What’s wrong with me?

• Should my daughter get the new HPV vaccine?

Questions & Answers

Question

I am 67 years old and have gone off my HRT. It seems I have less sensation with sex and that my vagina does not seem as firm with intercourse. Is this from stopping my estrogen?

Answer

Yes. Estrogen causes the vaginal walls to be plump, pink and thick. With estrogen deficiency the vaginal walls become very thin and pale. The vaginal walls lose their normal folds. The lack of estrogen also causes the nerves in the vaginal region to have less sensation and the blood vessels are affected so that not as much blood flow occurs in the vaginal area. With sexual activity, the vagina does not get as engorged with blood, there is less lubrication, and less sensation.

If you do not wish to restart systemic hormone therapy (such as a patch or oral pill), you could “re-estrogenize” your vagina with topical estrogen. Options include:

• Estrace Vaginal Crème
• Premarin Vaginal Crème
• Vagifem (a small tablet inserted into the vagina)
• Estring ( a small ring that is inserted into the vagina and releases estrogen in a small amount daily—this has to be changed every 3 months)

You should see results within 4-6 weeks, but you can continue to notice improvement for the first 12 weeks of therapy. Talk to your gynecologist about your options!