Nonhormonal vaginal therapies for menopause

Vaginal moisturisers or lubricants are nonhormonal therapies that can be used if vaginal dryness is the only symptom of menopause. Although less effective, they are a useful option if there is a contraindication to (or preference not to use) intravaginal estrogen therapy.

Vaginal moisturisers or lubricants are either water-based or silicone-based; silicone-based formulations are more effective (eg Pjur, Replens, Sylk, Acigel-Restore).

Vaginal moisturisers can be used daily to relieve symptoms of vaginal dryness but do not help other urogenital symptoms of menopause. Vaginal lubricants are used as required for sexual activity.

If nonhormonal vaginal therapies are ineffective or other urogenital symptoms are present (eg dyspareunia, urinary frequency, dysuria, nocturia, urgency), consider intravaginal estrogen therapy and nonhormonal therapies for urinary symptoms in menopause.

Vaginal laser therapy is not currently recommended for management of vaginal dryness or dyspareunia because evidence of efficacy is lacking.