Post menopausal vagina dryness. Any non hormonal recommendations?

Dear Silvabell,

Thank you for getting in touch, and welcome back to our online community.  My name is Lisa, and I’m one of the Cancer Information Nurse Specialists on the Macmillan Support Line.   I can see that you also belong to our breast cancer forum.  I hope that you are finding this forum supportive and a way to share experiences. 

I can appreciate that you feel terrified that problems that you experienced previously with vaginal dryness will return, and it does sound like these symptoms were quite severe, so it’s understandable that you’re worried.

As we aren’t part of the NHS, we, unfortunately, wouldn’t have access to your medical records.  Therefore, we wouldn’t have details about your breast cancer diagnosis.  However, if you’ve been told to stop taking the Vagirux pessaries by your doctor, then it is important that you follow their recommendations. 

As you may already be aware, some breast cancers are oestrogen receptor positive (ER positive).  Hormone receptor positive breast cancer uses hormones in the body to help it grow.  Therefore, cancer treatments work by blocking or reducing the amount of oestrogen in the body. 

However, oestrogen helps maintain the vagina’s moisture and elasticity.  A lack of oestrogen, therefore, can cause vaginal dryness or irritation, which can affect many aspects of one’s life.  As such, hormone replacement therapy is not normally recommended for people after a breast cancer diagnosis as the hormones may increase the risk of a new breast cancer or a recurrence. Equally, with vaginal oestrogen, which is a local HRT, its use it not suitable for everyone. 

Your breast consultant or breast nurse specialist is best placed to advise about its use in your situation.  If you haven’t already spoken to your consultant or nurse, we would suggest discussing the severe symptoms you experienced in the past and your concerns about these symptoms returning.  It may also be helpful to look at our information about vaginal changes.

You can also have access to see a menopause specialist on the NHS, for additional support.  Your GP or clinical nurse specialist can refer you.

Your GP has recommended a vaginal moisturiser to try, which is a non-hormonal management and is generally advised to be tried first.  There are several different types of vaginal moisturisers.  However, vaginal moisturisers do not reverse the changes experienced with lower oestrogen levels so it may mean ongoing use of these types of moisturisers.

There are also vaginal lubricants, which are shorter acting than moisturisers, and they provide temporary relief.  There are different preparations, and sometimes it may mean trying different brands to see which you prefer.

I hope this helps.  However, we often find that we can help more by exploring these questions over the phone.  You can also speak with the Macmillan Support Line team of experts.  Phone free on 0808 808 00 00 (7 days a week, 8am to 8pm) or send us an email.

Take care and best wishes,

Lisa R

Cancer Information Nurse Specialist

Ref/ VG/LiR

Thank you Lisa for your detailed answer. My cancer is oestrogen sensitive.

I think I will request a lubricant in addition to the moisturiser and see how this goes. I did not know I could be referred to a menopause specialist if necessary.

I very much appreciate your support and understanding. I did not realise that vaginal dryness could be such a debilitating problem and having the pessaries taken away (which solved the problem) has created extra anxiety on top of dealing with a cancer diagnosis.

Many thanks