Why Are Only 9% Of Women Getting This Treatment?

May 5

Written By Ascend Hormone Care

I CAME ACROSS A STATISTIC RECENTLY THAT STOPPED ME IN MY TRACKS:

Only 9% of women diagnosed with genitourinary syndrome of menopause (GSM) are using vaginal estrogen.

That’s… shockingly low.

Not because it doesn’t work.
Not because it isn’t safe.

But because so many women have been taught to be afraid of it.

Here’s what I see every day in practice:

Women struggling with vaginal dryness, painful sex, recurrent UTIs, and irritation—often for years—without being offered one of the most effective treatments we have.

And when vaginal estrogen is brought up, it’s often met with hesitation:

“What about cancer risk?”
“Isn’t there a black box warning?”
“I thought estrogen wasn’t safe for me…”

These are valid questions. But they deserve clear, evidence-based answers.

Here’s what the data actually tells us:

Low-dose vaginal estrogen is not the same as systemic estrogen.
It has minimal absorption and remains within postmenopausal hormone levels.

And organizations like the North American Menopause Society support its use—even in certain women with a history of breast cancer—when symptoms are significantly impacting quality of life and non-hormonal options aren’t enough.

So why the disconnect?

Part of the issue is labeling.

The U.S. Food and Drug Administration currently requires the same black box warning on both systemic estrogen and low-dose vaginal estrogen—even though their risk profiles are very different.

This has created a lot of confusion—and a lot of unnecessary fear.

The good news?
That warning was actively challenged by menopause experts as outdated and misleading. As of November 2025, the black box warning is now being removed from vaginal estrogen!

📚 Want to read the study?
Here’s the research this statistic comes from:
Gallo K, Zhang CA, Burton C, Kamdar N, Enemchukwu EA. Vaginal Estrogen Utilization Among Medicare Beneficiaries With Genitourinary Syndrome of Menopause. JAMA Netw Open. 2025;8(12):e2549822. doi:10.1001/jamanetworkopen.2025.49822

Here’s what I want you to take away:

If you’ve been told “you can’t use estrogen,” or you’ve been silently dealing with symptoms that are affecting your quality of life…

…it’s worth having a deeper conversation.

Because you deserve options.
And you deserve care that’s based on current evidence—not outdated fear.

If this is something you’ve been struggling with, I’d love to help you navigate your options.

You can schedule a visit with me here:
www.callienp.com

Ascend Hormone Care

BIO for website:

I’m Callie Riley, a Family Nurse Practitioner and the founder of Ascend Hormone Care. I’ve spent my career helping women navigate every stage of life, from adolescence to pregnancy and beyond. After years of working in OBGYN and Women’s Health, I saw firsthand how many women struggled with hormone imbalances—often feeling unheard, dismissed, or left without real solutions. That’s why I started Ascend Hormone Care—to provide women with the care, knowledge, and support they deserve.

I’ve been a nurse practitioner since 2019 and have dedicated my practice to helping women feel their best through evidence-based hormone therapy. My approach is rooted in education, empowerment, and compassionate care, ensuring that every patient feels heard and confident in their treatment plan.

When I’m not working with patients, you’ll find me exploring the mountains of Colorado with my daughter. Whether it’s hiking, snowboarding, or fishing, I love spending time outdoors and embracing everything this beautiful state has to offer.

At Ascend Hormone Care, my goal is simple: to help women regain their energy, confidence, and well-being so they can thrive at every stage of life. I’d love to be part of your journey.

https://www.callienp.com