What are some nonhormonal treatments that can improve vaginal dryness in women with a history of breast cancer? — Name withheld on request

Nonhormonal treatments for vaginal dryness predominantly consist of vaginal lubricants and lifestyle modifications. Women with vaginal dryness should avoid the use of scented products, such as pantiliners and soaps, as these may increase irritation to the area.

Another important issue is smoking. Use of tobacco products is associated with anticholinergic effects, and can worsen vaginal dryness. Women complaining of vaginal dryness who are current tobacco users should be counseled regarding smoking cessation to help improve their symptoms as well as the myriad of other health benefits associated with smoking cessation.

Extending foreplay as well as regular sexual activity may also benefit women with vaginal dryness that causes discomfort during sexual activity.

Other nonhormonal interventions include vaginal lubricants. Short-acting lubricants used before sexual activity (eg, Astroglide, KY Jelly) may reduce discomfort during intercourse, and long-acting lubricants used on a regular basis (eg, Replens) may reduce vaginal itching and irritation.

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Ospemifene (Osphena) is a selective estrogen receptor modulator, available as an oral pill, used to treat postmenopausal vaginal atrophy and discomfort. Ospemifene is not recommended for use in women with a history of breast cancer as it has not been adequately studied in this population.1

Women with vaginal symptoms should also be encouraged to discuss their symptoms with a gynecologist and undergo a thorough evaluation for any other contributing factors.

Reference

1. Osphena [package insert]. Florham Park, NJ: Shionogi Inc; 2015.