Post-menopausal vaginal atrophy can be treated with which local therapy?

• A. Estrogen cream.
• B. Oral estrogen pills.
• C. Corticosteroid cream.
• D. Boric acid solution.

Answer: (A)

When estrogen levels drop after menopause, the vaginal mucosa becomes thin, drier, and more fragile, leading to atrophy and symptoms like itching, irritation, and dyspareunia. Restoring estrogen directly to the vaginal tissue helps reverse these changes by promoting maturation of the vaginal epithelium, improving lubrication, and increasing elasticity. A topical estrogen product applied inside the vagina delivers this effect with minimal systemic absorption, making it the most appropriate local therapy for vaginal atrophy.

Systemic options like oral estrogen pills would provide estrogen throughout the body and come with broader risks, which isn’t necessary when the goal is to treat localized vaginal symptoms. A corticosteroid cream doesn’t address the underlying estrogen deficiency and can potentially irritate or thin the skin further. Boric acid is not used to treat vaginal atrophy; it’s more for specific infections or pH issues. Therefore, estrogen cream is the best choice for local therapy.