Q: I suffer from vaginal dryness and frequent urinary tract infections. The discomfort is ruining my sex life! Are there bioidentical hormones that can help?

A: It may be the case that you have an estrogen deficiency, which can lead to vaginal dryness and predispose you to frequent urinary tract infections (UTI’s).

Some women have great success with estriol vaginal cream or gel to help vaginal irritation, dryness, and frequent UTI’s (cystitis). It may be all you need for your vaginal dryness and UTI’s.

Estriol (E3) is a bioidentical hormone that is produced in women’s bodies in large amounts by the placenta during pregnancy and in relatively small amounts by the liver and other fat tissue. Sometimes called the "forgotten estrogen," estriol is considered to be the most therapeutic estrogen for the vaginal lining, cervix and vulvar tissues, but exerts only a weak effect elsewhere in the body. Estriol is quite good at "plumping up" these delicate tissues to reverse vaginal dryness, irritation and atrophy.

Currently, estriol vaginal creams and gels can only be obtained from a compounding pharmacy.

A second, stronger form of estrogen known as estradiol (E2) is also sometimes prescribed to treat inflammation of the vagina (atrophic vaginitis). Bioidentical estradiol is commercially available in regular pharmacies in the form of vaginal cream (brand name Estrace), vaginal tablets (Vagifem), and an insertable vaginal ring (Estring, which needs to be changed every three months). Bioidentical estradiol is also available from compounding pharmacies.

Depending on the severity of your symptoms, one of the above bioidentical options may be just right for you. You may need to work with your provider for a while to get the right dosage. One advantage to using compounded bioidentical hormones is that your healthcare provider can customize your dose, combining hormones as necessary, expressly to meet your needs.

See our symptoms section for an overview of additional natural measures you can take to help vaginal dryness.

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