Pascoe Pascofemin is a homeopathic remedy to relieve symptoms associated with menopause, PMS, and other hormonal disturbances such as hot flashes, sleep disorders, bloating, mood swings, irritability, breast tenderness, abdominal pain, and headaches. It is suitable for adults and children 12 years and up and made with naturally sourced medicinal ingredients including Agnus castus, Pulsatilla, Lilium tigrinum, and Cimicifuga.

Pascofemin Drops include the ingredient Fraxinus Americana. This key ingredient is widely used to help treat symptoms typically associated with menopause, such as hot flashes and mood changes. As well, it is also widely used to help treat uterine fibroids. The other active ingredients work to help relieve menstrual problems and other hormonal disturbances. The oral drops should be taken diluted in a little water.

Homeopathic remedy used to relieve symptoms associated with menopause PMS and other hormonal disturbances such as:

• hot flashes
• sleep disorders
• bloating
• mood swings
• irritability
• breast tenderness
• abdominal pain and headaches

Each tablet contains:
Agnus castus 2X 0.2g, cimicifuga 3X 0.2g, aletris farinosa 3X 0.075g, pulsatilla 4X 0.075g, heliconias dioica 3X 0.075g, lilium tigrinum 3X 0.075g, Ignatia 4X 0.075g, senecio aureus 5X 0.075g, caulophyllum 2X 0.075g and fraxinus americana 3X 0.075g. Contains 34% vol. alcohol.

NPN: 80026945

Once a dreaded phase of life, menopause is now regarded as an empowering passage—a time when all a woman has experienced and learned comes to fruition. No longer seen as merely the end of fertility, menopause is finally being recognized for what it actually brings—a phase of life that is ripe with freedom and opportunity.

Many of Nature’s plants and fungi are noted both scientifically and anecdotally for helping ease the transition through menopause. Not all are effective, and some—such as soy—have been linked to dangerous mutations. All ingredients in Purica® REBALANCE Menopause Relief have been carefully assessed, to ensure you derive maximum benefit, at minimal risk.

• Help control hot flashes and night sweats
• Help prevent mood swings
• Enhance youthfulness of skin, hair and nails
• Ameliorate stress
• Enhance libido
• Help prevent vaginal dryness
• Sop annoying skin itch/tingling (paresthesia)
• Encourage restful sleep
• Increase energy

Homeopathic remedy used to relieve symptoms associated with menopause PMS and other hormonal disturbances such as:

• hot flashes
• sleep disorders
• bloating
• mood swings
• irritability
• breast tenderness
• abdominal pain and headaches

Black Cohosh helps restore the balance of hormone levels for effective relief from the symptoms of menopause and perimenopause.

Natural Factors Black Cohosh delivers 40 mg of standardized herb per capsule to guarantee 2.5% tripterpene glycosides, the main active constituent in black cohosh responsible for balancing hormones and relieving symptoms.

• Helps balance reproductive hormones
• Supports menopause symptoms like night sweats and hot flashes
• Helps relax muscles
• Natural alternative to hormone replacement therapy
  

For many women, the transition from pre- to post-menopause can be arduous. Changing hormone levels can lead to increased risk for both heart disease and osteoporosis, while inducing uncomfortable shorter-term issues such as vasomotor symptoms (hot flushes, night sweats), insomnia, vaginal dryness, mood changes, and reduction in libido.

MenoVantage PE is a potent formulation of botanicals and nutrients at clinically relevant doses for reducing peri-menopausal symptoms. Black cohosh (Actaea racemosa) is one of the most studied botanical extracts for menopausal symptom relief. Randomized double-blinded trials have shown a reduction in climacteric symptoms without an estrogenic effect when a standardized extract is used. Chasteberry (Vitex agnus-castus) extract is well known for modulating FSH/LH levels and mitigating premenstrual symptoms, and holds promise for reducing menopausal symptoms as well, particularly difficulty sleeping. Dong Quai (Angelica sinensis) has a long history of use in traditional medicine for reducing menopausal symptoms.

The traditional botanicals found in MenoVantage PE are complemented by gamma-oryzanol, derived from rice bran. This natural substance has been found not only to reduce menopausal symptoms in 85% of participants, but also to improve cardiovascular risk factors, including LDL-cholesterol, a concern for many perimenopausal women. Hesperidin, a citrus bioflavonoid derived from oranges, provides relief for vasomotor symptoms of menopause, as well as potent anti-inflammatory and metabolic benefits.

• Dong Quai Extract (Angelica sinensis) (root) 100 mg
• Chasteberry Extract (Vitex agnus-castus) (fruit) 80 mg
• Black Cohosh Extract (Actaea racemosa) (root, rhizome) 80 mg
• (2.5% Triterpene Glycosides as 27-deoxyactein)
• Gamma-Oryzanol (Oryza sativa) (seed bran) 75 mg
• Hesperidin (Citrus sinensis) (fruit) 30 mg

Non-Medicinal Ingredients:
Vegetarian capsule (carbohydrate gum [cellulose], purified water), microcrystalline cellulose, vegetable grade magnesium stearate (lubricant), silica.

Contains no artificial colours, preservatives, or sweeteners; no dairy, starch, sugar, wheat, gluten, yeast, soy, egg, fish, shellfish, animal products, salt, tree nuts, or GMOs. Suitable for vegetarians/vegans.

2 capsules at breakfast and 2 capsules at bedtime per day or as directed by a health care practitioner. Use for a minimum of 3 months to see beneficial effect. Consult a health care practitioner for use beyond 6 months.

Sealed for your protection. Do not use if seal is broken. For freshness, store in a cool, dry place.

Consult a health care practitioner if symptoms persist or worsen. Consult a health care practitioner prior to use if you have a family history of cancer, have a liver disorder or develop symptoms of liver trouble, if you are taking blood thinners/anticoagulants, hormone-containing medications such as progesterone preparations, oral contraceptives or hormone replacement therapy, if you are taking any prescription medications or are breastfeeding. Discontinue use and consult a health care practitioner if you experience breast pain, discomfort and/or tenderness, increased menstrual bleeding time or if menstruation is delayed or absent. Do not use if you have diarrhea, haemorrhagic diseases, hypermenorrhea/profuse menstrual flow/heavy periods, allergy/hypersensitivity to members of the Apiaceae/Umbelliferae family (anise, caraway, carrot, celery, dill parsley), or if you are pregnant. Keep out of reach of children.

Do not use if you are using anticoagulant/antiplatelet medications (warfarin; Ticlid). As black cohosh may interact with CYP2E1 and CYP2D6 substrates, practitioners should be aware of potential drug interactions. The use of vitex is contraindicated in conjunction with bromocriptine, metaclopramide, dopamine agonists and antipsychotic drugs.

Vaginal dryness has many possible causes and can lead to discomfort, itching, and pain to those afflicted, sometimes severely enough to impact daily life.

Hyaluronic acid is made naturally by our bodies. Our groundbreaking Vaginal Moisturizer Gel, compounded especially for the Menopause Chicks community by our own Pure Pharmacy pharmacists, is made with pure hyaluronic acid and vitamin E to restore moisture and repair damaged skin.

Studies show that hyaluronic acid moisturizers are equivalent in effectivity to hormonal treatments (1). As it's non-prescription, patients can also take control of their own treatment, adjusting the frequency of application to meet their specific needs.

1. Chen J, Geng L, Song X, Li H, Giordan N, Liao Q. Evaluation of the Efficacy and Safety of Hyaluronic Acid Vaginal Gel to Ease Vaginal Dryness: A Multicenter, Randomized, Controlled, Open‐Label, Parallel‐Group, Clinical Trial. The Journal of Sexual Medicine. 2013;10(6):1575-1584.

• No prescription needed - use as much or as little as you need!
• Contains hyaluronic acid and vitamin E
• Our robust air-tight pump bottle delivers a precise 0.5 gram dose with each press, preventing contamination and quality loss from oxydization and keeping the product fresh for as long as possible
• Free of dyes, ethanol, gluten, parabens, and propylene glycol

• 30gm: 2+ months
• 60gm: 4+ months (not recommended for best product quality)
• 90gm: 6+ months (not recommended for best product quality)

• 30gm: 1+ months
• 60gm: 2+ months
• 90gm: 3+ months

• 30gm: 15+ days
• 60gm: 1+ months
• 90gm: 1.5+ months

May increase vaginal discharge upon first starting. Amount of discharge often decreases after first 2 weeks. It is recommended to try the product for at least 3 weeks before deciding to discontinue. In rare cases, some patients may experience burning/irritation when using a vaginal product. If this occurs, and is not mild, please discontinue use.

This water-based personal lubricant is made with hydroxyethylcellulose, a plant-based material shown to be hypoallergenic. BioNude also features a patented Bio-Match® technology - it closely mimics natural feminine moisture and helps maintain a healthy pH balance.

BioNude is a slippery, effective lubricant for enhancing pleasure and is formulated to help you avoid irritation or adverse allergic reactions. There is no added flavor or fragrance, no parabens, no glycerin, and no petrochemicals. Because it’s water-based, BioNude is fully compatible with toys, safe to use with latex condoms and cleans up easily.

A certified organic, water-based lubricant that is pH-balanced while helping you enhance your love life naturally. Made with aloe vera and infused with lemon and vanilla for a light flavor, this organic formula provides long-lasting glide without irritating chemicals or sticky cleanup.

• 4 oz. (120mL) / 1.5 oz. (44ml) 
• Not made with petrochemicals, parabens, or glycerin
• Safe with toys, latex and polyisoprene condoms
• pH-balanced and iso-osmolar

Organic Aloe Barbadensis Leaf Juice, Xanthan Gum, Agar, Lactic Acid, Potassium Sorbate, Sodium Benzoate, Natural Flavour

Maca (Lepidium meyenii), a plant native to Peru, is a cruciferous, mineral-rich plant whose roots are eaten as a vegetable by the indigenous peoples. Maca balances the effects of major steroid hormones such as estrogen, progesterone, and testosterone, and seems to create effects that are specific to the condition of the individual, elevating low levels of some hormones while lowering levels of hormones present in excess. Health professionals who use Maca in their practices thus report that Maca assists in the maintenance of sexual function in aging men and women, and can be helpful in normalizing menopausal and premenstrual symptoms in women.

As an adaptogen (a substance that helps the body adapt to stress), Maca has been shown to support bone structure, fight stress, increase energy, and promote balanced blood glucose levels and cardiovascular health.

NPN: 80042647

• A Peruvian root traditionally used as an adaptogen
• Supports sexual function & psychological wellbeing for men and women
• Helps relieve menopausal symptoms and balance hormone levels
• Socially & ecologically responsible harvesting

Lepidium meyenii (Maca) root extract - 750 mg

Non-medicinal Ingredients:
microcrystalline cellulose, maltodextrin, sodium stearyl fumarate. Capsule: hypromellose.

Fem Adapt is AOR’s premium menopause formula that is especially useful for hot flashes. While many formulas on the market contain ingredients with minimal research in menopausal women, doses that are too low or unstandardized botanical extracts, Fem Adapt provides the most powerful, clinically studied, standardized phytoestrogens in research-backed doses. Fem Adapt contains flax lignans, soy isoflavones, black cohosh and a standardized hops extract, which collectively can reduce the severity and frequency of hot flashes and other menopausal concerns.

AOR’s Fem Adapt formula not only provides safe and effective relief from menopausal symptoms, but also provides protection against health problems for which the risk increases after menopause, such as cardiovascular complications, osteoporosis and others. This is due to the mild estrogenic activity of the phytoestrogens in the product, which can serve as natural hormone replacement therapy.

Additionally, some of the ingredients in Fem Adapt have been used in herbal medicine to help relieve premenstrual symptoms, including abdominal cramps, muscle and joint pain, nerve pain like sciatica and nervous tension.

NPN: 80034694

• Helps reduce hot flashes and night sweats while also promoting mood balance
• Helps balance hormones, reducing the risk of post-menopausal diseases
• Provides four of the most effective and research-backed phytoestrogen

Linum usitatissimum L. extract (Flax seed)168 mg
Soy Isoflavone extract 60 mg
— Total isoflavones18.2 – 27.4 mg AIE
Black Cohosh extract80 mg
LIFENOL Hops extract 120 mg

Non-medicinal Ingredients:
Microcrystalline cellulose, silicon dioxide, maltodextrin and tricalcium phosphate.

Consult a health care practitioner prior to use if you are breastfeeding, taking blood thinners, have a history of hormonal or gynecological disease including ovarian cancer, endometriosis or uterine fibroids, have a liver disorder or develop liver-related symptomsn (e.g. abdominal pain, jaundice, dark urine), are taking hormone replacement therapy (HRT) including thyroid hormone replacement therapy or have depression or related diseases. Discontinue use and consult a health care practitioner if you experience breast pain, discomfort or tenderness or if you experience a recurrence of menstruation and/or uterine spotting.

Consumption with alcohol, other medications or natural health products with sedative properties is not recommended. Some people may experience drowsiness. Exercise caution if operating heavy machinery, driving a motor vehicle or involved in activities requiring mental alertness. Hypersensitivity such as an allergy has been known to occur in rare cases, in which case discontinue use. Consult a health care practitioner if symptoms persist or worsen, or for use beyond one year.  This product contains corn and soy derived ingredients, do not use if you have such allergies.

Douglas Estro-Mend is a soy-free blend of herbs used in herbal medicine that helps ease nervous tension while relieving pain associated with menstruation and symptoms associated with menopause.

A complex interaction of hormones regulates menstruation. Imbalances of hormones, including estrogen, can result in menstrual pain and premenstrual symptoms, which often include changes in mood, energy, attention, appetite, sleep, physical comfort (breast tenderness, bloating) and quality of life. Phytoestrogens, including black cohosh, mimic the functions of estrogens without proliferative actions and help relieve menstrual pain and premenstrual symptoms.

Significantly less estrogen is produced in the period before menopause. Hormonal fluctuations during this time can result in common menopausal symptoms, including hot flushes and vaginal dryness. Phytoestrogens also support and minimize the changes and symptoms that are sometimes experienced during menopause. Studies have found that black cohosh helps relieve menopausal symptoms, such as hot flushes, excessive sweating, insomnia, and vaginal atrophy. As menopause may result in sleep disruption, Estro-Mend also contains hops, which can relieve nervousness and aid sleep.

NPN: 80040917

• Used in herbal medicine to help relieve premenstrual symptoms and pain associated with menstruation and helps to relieve symptoms associated with menopause

PMS Support contains a combination of ingredients including BioResponse DIM^®, magnesium, iron and B vitamins. It also contains chasteberry to help relieve menstrual symptoms and stabilize menstrual cycle irregularities. Premenstrual symptoms affect approximately 40% of women and may be associated with elevated levels of the hormone prolactin. Chasteberry extract (Vitex agnus-castus) is used in Herbal Medicine as a hormone normaliser and to help relieve menstrual symptoms. It contains active constituents that play a role in hormone activity, including dopaminergic compounds that suppress the release of prolactin. Studies have shown that chasteberry extract supplementation helps relieve premenstrual symptoms, including mood, headache, bloating, and breast fullness.

Diindolymethane (DIM) is a natural component derived from indole-3-carbinole and cruciferous vegetables. BioResponse DIM is the only form with proven absorption demonstrated in independently performed clinical studies.

Iron supplementation is helpful in menstruating women to support the maintenance of good health. PMS Support provides a carbonyl form of iron that is bioavailable and well tolerated. Magnesium has been noted to fluctuate across the menstrual cycle and is involved in many cellular pathways. It helps to maintain proper muscle function by decreasing cramping. B vitamins are also included to help promote energy production.

NPN: 80063027

• Premenstrual symptoms
• Menopause

Vitamin D3 (cholecalciferol) 12.5 mcg (500 IU/ UI)
Thiamine (thiamine hydrochloride) 12.5 mg
Vitamin B6 (pyridoxal 5'-phosphate) 9.5 mg
Folate (calcium L-5-methyltetrahydrofolate) 200 mcg
Ferronyl ®MD Iron (carbonyl iron) 9 mg
Magnesium (magnesium chelate√) 100 mg
BioResponse DIM®50 mg Providing 12.5 mg
Chaste Berry Fruit Extract (Vitex agnus-castus) (7-10:1) (350-500 mg dried equivalent) 50 mg

Non-medicinal ingredients:
Hypromellose (capsule), cellulose, magnesium stearate, silica, starch, vitamin E, phosphatidylcholine (from sunflower)

Adults: Take 1 capsule 2 times daily with food, a few hours before or after taking other medications or natural health products, or as directed by your healthcare practitioner. Use for a minimum of 3 months to see beneficial effects

Do not use if pregnant or breastfeeding. Consult your healthcare practitioner prior to use if you are attempting to conceive, have a liver disorder or symptoms of low estrogen, are taking hormone-containing medications such as progesterone preparations, oral contraceptives, hormone replacement therapy, other medications or natural health products.

Discontinue use and consult your healthcare practitioner if you develop liver-related symptoms or symptoms of low estrogen. Folate supplementation can mask vitamin B12 Consult your healthcare practitioner prior to use if unsure whether you are taking enough vitamin B12. Consult your healthcare practitioner if symptoms persist or worsen. Use only if safety seal in intact. Store in a cool, dry place

• Relief for Menopausal Mood Changes

Motherwort (Leonurus cardiaca) 4:1 aerial parts extract equivalent to 400 mg of motherwort 100 mg
Black Cohosh (Actaea racemosa) root & rhizome extract 80 mg
Lemon Balm (Melissa officinalis) 4:1 leaf extract equivalent to 200 mg of lemon balm 50 mg

Take one tablet twice daily or as directed by your healthcare practitioner.

Consult your healthcare practitioner before use

• Formulated to provide support for women with menopausal symptoms such as hot flushes, insomnia, low mood, decreased libido and poor cognition
• Herbal extracts are highly concentrated with standardization to active ingredients such as ligustilides, 27-deoxyactein and hypericin
• Quercetin and hesperidin are included to improve the integrity of blood vessels and reduce hot flashes

Dong Quai extract (Angelica sinensis) 5:1, 1% ligustilides 60mg
Black cohosh extract (root and rhizome, Actaea racemosa) 3:1, 2.5% triterpene glycosides 50mg
Hesperidin 125mg
Quercetin 125mg
Chasteberry extract (fruit, Vitex agnus-castus) 10:1 50mg
Wild yam extract (root, Dioscorea villosa) 10:1 50mg
St. John’s Wort extract (herb top, Hypericum perforatum) 4:1, 0.3% hypericin 30mg
Red clover extract (flower, Trifolium pratense) 10:1 20mg

Non-Medicinal Ingredients:
Vegetable-grade magnesium stearate, microcrystalline cellulose, maltodextrin, silicon dioxide. Capsule: hypromellose.

Adults - Take 2 capsules 2 times per day before meals or as directed by a healthcare professional.

Do not use if safety seal is broken. Discontinue use and consult a healthcare professional if menstruation is delayed or absent, or if you experience increased menstrual bleeding time. Consult a healthcare professional prior to use, especially if you have a family history of cancer, a liver disorder or develop symptoms of liver trouble, or if you are taking any prescription medications, anti-anxiety medications, seizure medications, antihistamines, bronchodilators, muscle relaxants and/or opiates, hormone-containing medications such as progesterone preparations, oral contraceptives, birth control pills or hormone replacement therapy. Consult a healthcare professional if symptoms persist or worsen. Avoid prolonged exposure to sunlight, ultraviolet light (UV) or UV therapy.

Contraindications: Do not use if you are pregnant, breastfeeding or taking anti-cancer medications, blood thinners/antidepressants medications (e.g selective serotonin reuptake inhibitors (SSRI), anti-HIV agents, cardiovascular medications, immunosuppressants, and/or contraceptive medications. Do not use if you have diarrhoea, haemorrhagic diseases, hypermenorrhoea/profuse menstrual flow/heavy periods, or allergy/hypersensitivity to members of the Apiaceae/Umbelliferae family (anise, caraway, carrot, celery, dill, parsley).

Vitex or Chaste tree is a traditional woman’s dietary supplement. Vitex is widely used to promote overall health and balance in a woman’s cycle.

Evening primrose is native to North America. Originally used for the treatment of asthma, stomach and digestive disorders, and bruises, there is renewed interest in the herb because of the oil in this plant. Approximately 70% of the oil is cis-linoleic acid, and as much as 9% cis-gamma-linolenic acid (GLA). The oil also contains campestrol and beta-sitosterol. GLA is an essential polyunsaturated fatty acid that the body converts to a hormone-like substance called prostaglandin E1 (PGE1). PGE1 has anti-inflammatory properties and may also act as a blood thinner and blood-vessel dilator.

The anti-inflammatory properties of EPO have been studied in double-blind research with people suffering from rheumatoid arthritis. Some, but not all, studies have reported that EPO supplementation provides significant benefits to these people. GLA, the primary active ingredient in EPO, has anticancer activity in test-tube experiments. Primrose oil has been used to treat the symptoms associated with premenstrual syndrome: irritability, headaches, breast tenderness, and bloating; it has also been helpful in the treatment of eczema. There are claims that increased doses help rheumatoid arthritis and slow the progression of multiple sclerosis.

Linoleic acid, a common fatty acid found in nuts, seeds, and most vegetable oils (including EPO), should theoretically convert to PGE1, but many things can interfere with this conversion, including disease, the aging process, saturated fats, hydrogenated oils, blood-sugar problems, and inadequate amounts of vitamin C, magnesium, zinc, and B vitamins. Supplements that provide GLA circumvent these conversion problems, leading to a more predictable formation of PGE1.

Used in herbal medicine: (1) to help relieve menopausal and premenstrual symptoms, as well as menstrual pain; (2) to ease nervous tension; (3) and to help relieve muscle and joint pain associated with rheumatic conditions and neuralgia.

Non-Medicinal

Studies show that moisturizing with hyaluronic acid is effective for the treatment of vaginal dryness (1).

Vaginal dryness is most commonly associated with menopause. When we reach menopause, estrogen goes for a steep decline, and so does hylaluronic acid. Hyaluronic acid is a naturally-occurring molecule that our body makes on its own keeping our eyes, mouth, skin, joints and vaginas naturally lubricated. But our body's hyaluronic acid starts to decline in our 30s and 40s, and then more significantly postmenopause. There are other reasons that can lead to vulva and vaginal dryness including: the birth control pill, postpartum, overuse of pads and pantyliners, certain cancer treatments and some medications and health conditions.

Feel Amazing Vulva and Vaginal Moisturizer is made from hyaluronic acid and vitamin e to restore natural moisturize back into the skin cells of the vulva and vaginal wall. Researched and developed by BC-based pharmacists in collaboration with vagina owners aged 35 and up. Health Canada approved with NPN (Natural Product Number) 80115673.

Feel Amazing can be purchased online without a prescription. This means you can take control of your vaginal health and apply the moisturizer as often as your own unique needs require, without having to consult a doctor first.

1. Chen J, Geng L, Song X, Li H, Giordan N, Liao Q. Evaluation of the Efficacy and Safety of Hyaluronic Acid Vaginal Gel to Ease Vaginal Dryness: A Multicenter, Randomized, Controlled, Open‐Label, Parallel‐Group, Clinical Trial. The Journal of Sexual Medicine. 2013;10(6):1575-1584.

Note: as they're not required, Feel Amazing doesn't come with an applicator. If desired, you can purchase one here for $2.

• Available for order online, without a prescription.
• Contains hyaluronic acid and vitamin E to safely and effectively restore moisture and repair damaged skin.
• Our pharmaceutical grade, high quality pump dispenser delivers precise doses of 0.5 mL per pump. This sterile, air-tight bottle prevents bacterial contamination and loss of potency from oxidation, keeping the product fresh for a lengthy shelf life.
• Currently available in 30mL size.

Each pump is 0.5 mL

Using your finger, apply 2 pumps of gel (1 mL) into the vagina once daily and apply to the vulva as needed.

If used at the recommended dosing, then 2 pumps daily will last approximately 30 days.

Medicinal ingredients:

• Sodium hyaluronate
• Vitamin E

Non-medicinal ingredients:

• Purified water
• potassium sorbet
• aloe barbadensis leaf extract
• allantoin
• glycerin
• tapioca starch
• lysolecithin
• sclerotium gum
• xanthin gum
• pullulan
• ammonium acryloyldimethyltaurate/VP copolymer
• tamarindus indica seed polysaccharide
• gluconolactone
• sodium benzoate

Free of dyes, ethanol, gluten, parabens and propylene glycol

Everyone is unique and at a different age and stage of dryness; prevention and treatment. How frequently you moisturize will depend on your personal needs. Since this product does not require a prescription and also has a long shelf-life, you have the freedom to use as much or as little as needed.

In rare cases, some patients may experience pain, irritation, burning, or vaginal discharge with foul smell. If this occurs and it is not mild, please discontinue use and consult a healthcare practitioner.

Please discontinue in the event of hypersensitivity or allergy. Avoid contact with eyes. Consult a healthcare practitioner if symptoms of vaginal dryness worsen or persist beyond 8weeks.