How can menopausal hormone therapy help with vaginal dryness?

Menopausal hormone therapy (MHT) helps alleviate vaginal dryness by restoring estrogen levels, which decline significantly during menopause. This decline often causes the vaginal mucosa to become thin, atrophic, and dry, a condition associated with the genitourinary syndrome of menopause (GSM).12

By restoring estrogen, MHT helps maintain the integrity of vaginal tissues and improves blood flow to mucosal surfaces. There are two primary ways this therapy addresses these symptoms:1

• Systemic therapy: This approach affects the entire body and can be used to manage various menopausal symptoms.1
• Local (low-dose vaginal) therapy: This method is specifically designed to target genitourinary symptoms, such as vaginal dryness and irritation, with minimal systemic absorption.12

Because estrogen applied directly to the vagina is not well absorbed into the general circulation, it acts primarily on local tissues to reverse atrophy and dryness. Clinicians typically individualize treatment plans, selecting the lowest effective dose and the most appropriate route of administration—such as vaginal creams or rings—to manage symptoms effectively while minimizing risks.21