Intravaginal DHEA for vaginal atrophy
So I just saw a new gynecologist and am very excited about working with her. She told me I had vaginal atrophy and said she wanted me to try intravaginal DHEA (1%) compounded (Shaefer Drugs in Florida) to help with this problem. I have mixed feelings about using any hormones, certainly just to make the pain in my vagina go away seems not a good enough reason. But I’ve read that not treating it can just worsen the condition. And the doctor said that they are finding that using DHEA instead of an estrogen cream causes none of the same problems. I’m still researching, but wanted to write a quick blog about this. I don’t know if this will help, but reading about vaginal atrophy leads me to think that there is a grain of truth in this exacerbating my pain. I don’t know, but I figure I’ll try it for three months.
Here is some information I’ve found about studies:
(From the Biomed Experts website)
The primary objective of this study was measurement of the systemic bioavailability of DHEA and its metabolites following daily intravaginal application of the sex steroid precursor. Forty postmenopausal women were randomized to receive a daily dose of one ovule of the following DHEA concentrations: 0.0%, 0.5%, 1.0% or 1.8%. After only 7 days of treatment, the maturation value of the vaginal epithelial cells was significantly increased while the vaginal pH was significantly decreased at all DHEA doses. These important local effects were observed while the serum concentrations of estradiol and testosterone remained within the values found in normal postmenopausal women at all DHEA doses. Similar observations were made for serum androstenedione, estrone, estrone-sulfate and DHEA-sulfate. Even at the highest 1.8% DHEA dose, serum DHEA was increased at the levels found in normal premenopausal women. The present data show that the intravaginal administration of DHEA permits to rapidly achieve the local beneficial effects against vaginal atrophy without significant changes in serum estrogens, thus avoiding the increased risk of breast cancer associated with the current intravaginal or systemic estrogenic formulations. In addition, the recent observation that DHEA is transformed into both androgens and estrogens in the vagina permits to exert benefits on all the three layers of the vaginal wall.
Isa Herrera, MSPT, CSCS,owns and operates Renew Physical Therapy, a leading healing center in New York City. She has dedicated her career to helping women find relief from conditions such as sexual and pelvic pain. Her goal is to always empower her patients with the tools they need to succeed on their own, which is what makes her phenomenal. 
So there is really no excuse! Plus, as will be evident in this interview, Isa is clearly a sincere, caring, knowledgeable provider. I cannot praise this book highly enough. 
