Dr. Tabatha Barber walks through alternatives to estrogen cream for vaginal dryness. Options include Replens moisturizer, the DHEA insert Intrarosa, Julva DHEA cream, and the Diva laser device, which stimulates collagen and can help with urinary leakage too.
Questions this video answers
Replens (OTC vaginal moisturizer).
Intrarosa (prescription vaginal DHEA insert).
Breast cancer and irregular vaginal bleeding without a diagnosis are listed as general contraindications.
Julva, created by Dr. Anna Kabeca (primary ingredient DHEA; non‑prescription cosmetic).
Diva vaginal laser (referred to as the Diva device).
Chapters
Hi, I'm Dr. Tabitha, the functional gynecologist. I'm a board certified OB, GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey. And I'm super excited to share my wisdom and unique perspective as it pertains to women's health. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place. I want to be your functional gynecologist. So welcome. Hi guys. Welcome back to the Functional gynecologist. I'm your host, Dr. Tabitha. Here's our little bonus episode. Question of the week Is estrogen cream my only option for treating vaginal dryness? Okay, so I went and spoke to a breast cancer support group last week and this was one of the main questions that they had, which is obviously super important. And the answer to that is absolutely not. There are other options that are safe and effective to treat vaginal dryness, painful intercourse, urinary leakage, itching and irritation while going through active treatment of breast cancer, or if you're breast cancer survivor, or if you're on estrogen receptor blockers like tamoxifen. So Replens. It's an over the counter vaginal moisturizer. It is for long term moisture associated with vaginal dryness. So you use it on a regular basis. Kind of like how you use lotion to keep your hands from being dry. The company claims that the ingredients have a polycarbophyl, which is an acidic, inert bioadhesive polymer that allows the product to attach to the walls of the vagina to produce increased moisture long term. It also contains mineral oil, hydrogenated palm oil, glycerin, sodium hydroxide, and sorbic acid. Some people may be allergic to this, but most people tolerate it pretty well. There have been studies proving its effectiveness and it's compatible with use of condoms. So it's nice that it's over the counter. You just have to go to the store and buy it. You don't have to see a physician. And it just helps with any vaginal dryness that you're experiencing. It, however, does not help with urinary leakage or laxity, and some women find it messy. It can be used with active breast cancer patients without any concern. Intrarosa is a prescription DHEA product. So dihydroepiando Drosterone is a precursor to estrogen and testosterone that's naturally secreted by your adrenal glands. So DHEA starts to decrease in levels around age 30, but it's super important for the integrity of your skin, muscle and bone health. Actually in men and women, healthy levels of DHEA have been proven to help with mental alertness, energy levels and has a role in maintaining your libido and heart health and other vital functions. So some people actually take a bioidentical DHEA oral supplement. But this product, Intrarosa, is a prescription strength vaginal insert that you can get from your physician. Normally it's used every night before bed. There is a general contraindication listed being breast cancer and irregular vaginal bleeding that has no diagnosis. Along those same lines, there's a product on the market called Julva J U L V A which is an all natural anti aging cosmetic cream that was created by the triple board certified OBGYN Dr. Anna Kabeca. So you can get that on her website@drannacabeca.com it's also primary ingredient is DHEA, but it's not a prescription strength. The website claims that it stops urinary leakage issues, helps with vaginal dryness, discomfort and sensation. It also improves the vaginal elasticity and tightening. I really like Julva because it is free of any additives, parabens, phthalates, it's non GMO and it's not tested on animals. The other ingredients are alpine rose stem cells, coconut oil. It has a botanical base, vitamin E, emu oil, shea butter, water, glycerin and an alcohol component for the antimicrobial part. So this is normally used every day for the first month and then about five times a week at bedtime for maintenance. Much like Intrarosa, the prescription vaginal insert. I would say because it's not prescription strength, some women may be able to safely use this during their breast cancer treatment or after. It's not recommended to use it if you are on tamoxifen or other estrogen blockers just because you don't want to mitigate the effects of that medication. Potentially my favorite option is the vaginal laser therapy. So vaginal laser came out of the aesthetics and plastics industry that treated facial and neck skin with light therapy. What we realize is that we can do these same light therapy treatments to the vaginal tissue to get the same results of tightening, increased cell turnover and a more youthful functioning skin layer. So in my office I use the Diva vaginal laser. It's a quick, convenient solution, minimal downtime. You know, you come into the office and have it done and a little bit later you're on your way, doing your thing. It's three days of no intercourse or anything in the vagina, but otherwise, there's no downtime. So women with active breast cancer or breast cancer survivors can have this treatment done. It's non hormonal, and that makes it an awesome option. So we insert a wand into the vagina, and the laser makes these miniscule little injuries to the vaginal walls. These little pin pricks are about 8% of the surface of the vagina, but it stimulates new collagen, increased blood flow to that area and elicits a he response so that you end up having thicker, more elastic vaginal walls that have increased moisture, much like before menopause. And because it's strengthening the collagen layer, you're getting more support under the bladder. So it helps with urinary leakage and urgency. So I think diva vaginal laser is the best option for actually all women. Even anyone who's had babies, you know, suffering from any mild leakage of urine, painful intercourse, just dryness and irritation in general. Definitely women who have had breast cancer or are on estrogen blockers post breast cancer. Everyone can benefit from the diva vaginal laser. So that answers the question of the week. Is estrogen cream my only option for treating vaginal dryness? Absolutely not. Ladies, there's lots of other options, so talk to your gynecologist or reach out to me at Facebook and Instagram @Doctor Tabitha and get a hold of me if you have more questions. Or you can come and see me if you're locally in Grand Haven, Michigan. You can also check me out on my website, www.drtabitha.com. so thanks for joining me today, ladies. I would love it if you'd give me a review. Five stars would be amazing. Let itunes know that you want to hear more of this information. It's important to you, so hit the subscribe button. That will tell them that. And then share these episodes with your friends. Tell other women to listen. It's super important that we get these messages out there and support each other. Now go out and have an awesome day. Sam.
