The Magic of Hormones
By Shayne Poulin, MD
Is there really a safe medication that can be used universally for half the population to reduce mortality and improve quality of life? What is this magic medication you ask? It’s vaginal estrogen! As highlighted in Dr Rachel Rubin MD ‘s blog post The Magic of Hormones (and backed by a mountain of data).
Using vaginal estrogen routinely in post-menopausal patients can significantly reduce genitourinary syndrome of menopause (GSM), specifically UTIs. UTIs are a significant cause of morbidity and mortality. The use of vaginal estrogen significantly reduces this risk. Given the very low systemic absorption, vaginal estrogen is safe for pretty much everyone with a vulva.
However, less than 10% of patients are being prescribed this potentially life saving medication. Many physicians did not receive robust training on menopause and hormone replacement. This can make physicians apprehensive to prescribe vaginal estrogen. Fortunately, in Dr. Rubin’s article she provides a dosing table to make prescribing easier. This knowledge has changed my own clinical practice and the quality of life for many of my patients.
