VEDA Study (DHEA vs Estradiol)

This study is being done to compare two vaginal treatments, vaginal estrogen and vaginal DHEA, that are used to treat vaginal and urinary symptoms related to menopause. These symptoms may include vaginal dryness, discomfort, painful intercourse, or urinary problems and can affect quality of life and sexual health. Women who choose to participate will be randomly assigned to use one of the two treatments for a set period of time. Participants will complete questionnaires about their symptoms and sexual health and have simple vaginal testing at the beginning and end of the study. The goal of this research is to better understand how these treatments affect vaginal health and sexual function so healthcare providers can make informed treatment decisions and improve care for postmenopausal women.

Inclusion Criteria: * Peri- or post-menopausal status * Presence of any genitourinary or vaginal symptom (e.g., dryness, itching, discomfort, dyspareunia) * Willingness and ability to use vaginal therapy * Ability to provide informed consent * English speaker * Ages 40-90 Exclusion Criteria: * Use of systemic hormone therapy within the last 6 months * Gynecologic malignancy * Known allergy to study medications * Active vaginal infection at enrollment * Prior pelvic radiation