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Hormonal Therapies

Hormonal pharmacotherapy for GSM, recurrent-UTI prevention, perioperative care, and gender-affirming treatment. The linked hubs distinguish approved indications and product-specific dosing from off-label use, surrogate tissue findings, and clinical outcomes. IMPROVE did not show better prolapse-repair success with routine estrogen priming. FDA menopausal-hormone labeling changes require checking each product.

For testosterone replacement in male hypogonadism see Sexual Medicine & Andrology. For GSM and Gender-Affirming Surgery clinical articles see the linked pages.

  • Vaginal & Topical EstrogenLocal estrogen for GSM and recurrent-UTI prevention; AUA/SUFU/AUGS 2025 guidance, formulation-specific dosing, cancer-survivor shared decisions, and the 2026 TAPER application trial.
  • Vaginal DHEA (Prasterone)Prasterone for menopausal VVA-related dyspareunia. Local metabolism includes estrogens and androgens; serum changes and breast-cancer uncertainties matter. No established superiority over vaginal estrogen.
  • OspemifeneOral SERM for menopausal VVA-related dyspareunia and dryness. Endometrial and thromboembolic warnings, food and interaction requirements; limited off-label urinary evidence.
  • Vaginal Moisturizers & LubricantsMoisturizers for regular dryness relief and lubricants for friction. Product-specific tolerability, condom compatibility, osmolality, and nonhormonal options for breast-cancer survivors.
  • Preoperative Hormonal PrimingIMPROVE 12-month/3-year and EVA 2026 results: patient-reported benefit versus repair durability, uncertain postoperative-infection benefit, and the separate 2025 pessary trial.
  • Gender-Affirming Hormone TherapySOC 8 and Endocrine Society framework, formulation-specific adult regimens, fertility and organ-based screening, VTE risk assessment, and individualized perioperative management.