Therapeutic target
Avoidance of painful cohabitation
Therapy recommendations
- Many causes are known for dyspareunia. For this reason, drug therapy can also be very diverse:
- Ovulation inhibitors
- Estrogens (e.g., for local therapy in “dry vagina” due to postmenopause): local estriol therapy (estrogen vaginal cream: see below Colpitis/drug therapy/atrophic colpitisNote: In breast carcinoma patients with vaginal atrophy due to. anti-hormonal therapy, ultralow-dose local estriol therapy (0.03 mg estriol) may be used despite hormone receptor positivity and aromatase inhibitor therapy. See also under “Further notes”.
- Dehydroepiandrosterone (DHEA) as vaginal inserts in postmenopausal women; according to the studies published by the manufacturer, there was also an increase in libido, excitability, lubrication and orgasm; the beneficial effects were maintained over 52 weeks.
- Antibiotics; antifungals (for specific colpitides/vaginitis).
Other notes
- Vaginal estrogen therapy did not increase the risk of mammary carcinoma (breast cancer), colorectal carcinoma (carcinoma of the colon (intestine) or rectum (rectum)), and endometrial carcinoma (cancer of the uterus) in users with an intact uterus; likewise, it did not increase the risk of apoplexy (stroke) or pulmonary or deep vein thrombosis.
- Lubrication of the vagina (lubricant) and the maintenance of healthy vaginal flora (administration of probiotics).
- Anti-inflammatory endocannabinoid-containing creams (active ingredient: N-palmitoylethanolamide, PEA; effect: mast cell stabilizing, immunomodulating and anti-inflammatory effect on the vaginal epithelium).
