Vaginal Dryness and Natural Progesterone

In the event progesterone cream alone does not resolve hot flashes and vaginal dryness, then small doses of estriol cream can make a difference. In actual fact, compounding pharmacists, in consultation with your GP, are equipped to individualised a BHRT treatment plan around whatever hormones need replacing based on your salivary analysis.

Women who are currently on a program of estrogen replacement therapy should perhaps give consideration to estriol cream as a safer alternative in the treatment of vaginal dryness and/or atrophy, severe hot flashes, urinary incontinence, painful intercourse, and other associated symptoms.

We know that estriol does not induce endometrial proliferation to the extent of the other estrogens. However, we do need to include a progesterone cream to balance the estrogenic effect of estriol.

As a treatment for osteoporosis, estriol significantly improved Bone Minerial Denisty by inhibiting bone resorption and therefore, estriol might be effective for use in HRT in elderly patients.

Estriol is able to be excreted easily from the body in the urine. It is water-soluble and as such does not need to be broken down by the liver; thus it does not build up in the body. For these reasons the safest estrogen to use is estriol applied to the vulva and lower vagina every day (except during cyclic breaks).

Please note, bioidentical progesterone, estriol and/or testosterone replacement therapy can be purchased from your compounding pharmacist as individual transdermal creams. But make sure you buy each hormone in a separate dispenser since you’ll need to adjust dosage according to periodic salivary hormone profiles.

It is recommended that estriol levels be measured when supplementing with a compounded preparation of bioidentical estrogens (e.g. "Biest" preparations contain estriol and estradiol OR "Triest" preparations containing estriol, estradiol and estrone).

Our reader Les shares her story,

"I’ve now been taking progesterone cream for 3 months, started to eat healthy balanced meals (no more vegan!) and I stopped taking the pill. The hot flashes stopped the very next day, no more mood swings, no more weeping, my skin has improved, I’ve lost 15lbs and kept it off. Another plus is that my libido has returned, and no more vaginal dryness."