Review of current and emerging estrogen receptor agonists for vaginal atrophy

Introduction Vulvovaginal atrophy (VVA) predominantly affects postmenopausal women due to hormonal decline but can also occur in premenopausal women with conditions such as primary ovarian insufficiency or exposure to anti-estrogen medications. Contributing factors include smoking and certain medical treatments. Symptoms like dyspareunia and loss of sexual function affect many women but are underreported due to stigma and lack of awareness. Current treatments range from over-the-counter lubricants to hormonal therapies like estrogen receptor agonists, which improve vaginal elasticity and moisture with minimal systemic absorption.