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Just typed this out once and it disappeared, so hoping this one works. I've been thinking - I believe that according to studies, and there are quite a few of them, the only things that will IMPROVE atrophy is either hyaloronic acid products (pessaries, creams etc.) or oestrogen pessaries or creams etc. Because of the risk of vaginal oestrogens on the uterus, my vote would go to the hyalaronic treatments because they're safer and they seem to give a pretty good result in comparison. BUT there are women who don't want to use either of these or can't, for some reason and I've been thinking so far that the answer then was moisturisation. So thinking oil based products would be the answer in one form or another, but there are still some who this just isn't working for. After my gynie suggested a water based lubricant to go round the bottom of my pessary (it's like a plastic shelf with a sort of coat hanger bit at the bottom that they use to help get it in and out, and the coat hanger bit was slightly uncomfortable initially) it got me thinking. I had some Yes water based lubricant (and by the way, I understand this is available on the NHS!) so am trying that. The water based one is advertised by the company to be used either instead of, or as well as, the oil based one - used over oil it makes it even more slippery. I'm now thinking for those women where the moisturisation isn't doing the job, I just wonder if a water based lubricant either with it, or even instead of it might work? My thinking has tended to be 'atrophy = dryness, so the answer is oil' but I'm seriously wondering if instead, or as well, the answer is lubrication! I don't THINK (but if anyone knows of any studies done that are different please tell me!) that moisturising actually improves the atrophy, but simply helps with the symptoms, so would lubrication (water based) help more, with the moisturiser, or on it's own? Any thoughts would be welcome. I might be completely going up the wrong street here but sort of fumbling through on thoughts.
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