Q: Do I need estrogen for healing?

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You say you’re four years into menopause. You started using a lubricant to ease painful intercourse, and then added a moisturizer when the lubricant was not quite enough. Your gynecologist has recommended vaginal estrogen cream or the Mona Lisa Touch procedure, and you’re wondering how to proceed. 

Lubricants and moisturizers (sometimes one product does both) can help ease the discomfort and slow the progression of painful intercourse and vaginal atrophy, but they will not restore health to the tissues. Restoration is best accomplished with localized (or vaginal) estrogen, Osphena (a very effective non-estrogen oral treatment), or Mona Lisa Touch laser therapy.

If the over-the-counter options are working for now, you can continue on that course and address with other therapies later. It’s likely, though, that time will come, since atrophy is an ongoing process.

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