Vaginal estrogen cream (cream inserted into the vagina that releases estrogen continuously)
Vaginal estrogen ring (inserted high in the vagina, releases daily estrogen for 3 months)
Vaginal tablet (inserted into the vagina twice per week)
How It Works
A low dose of estrogen released into the
vaginal area has a localized effect (only a small amount of estrogen is
absorbed into the bloodstream). This rebuilds the lining of the
urethra by promoting
A typical schedule
for low-dose prescription estrogen cream is 3 weeks of daily use followed by
twice-weekly use thereafter.
For dryness and irritation of the
external vaginal area (labia) only, you can rub a small amount of estrogen
cream onto the affected area. Many women find that twice a week is often
Why It Is Used
Since women are now generally
discouraged from using long-term
hormone therapy (HT) because of health
risks, low-dose vaginal estrogen is recommended for treating vaginal and
urethral (genitourinary) dryness and weakening after menopause. Because it is
low-dose and has a localized effect, it is thought to be a lower-risk treatment
than HT or estrogen alone (estrogen therapy, or ET).
Low-dose estrogen absorbed vaginally:
Helps maintain the muscle tone of the vagina
Reduces vaginal dryness, irritation, and
Reduces urinary tract irritation and tendency toward
How Well It Works
You can expect noticeable improvement
in vaginal dryness and sensitivity after a few weeks of vaginal estrogen
treatment. You will likely continue treatment as long as you have
Side effects may include:
Abnormal vaginal bleeding.
Avoid using estrogen cream during sexual intercourse. A
male sex partner regularly exposed to estrogen cream can develop enlarged
See Drug Reference for a full list of side effects.
(Drug Reference is not available in all systems.)
What To Think About
Vaginal estrogen may be used by
women with liver or gallbladder disease, for whom oral estrogen is not
Low-dose vaginal estrogen is generally not
progestin to prevent
endometrial (uterine) cancer because it is a lower
dose and is thought to have only a local effect. Use as low a dose as possible
to relieve symptoms.1
Talk to your doctor about using vaginal estrogen if you have had breast cancer.
Shifren JL, et al. (2010). Role of hormone therapy in the management of menopause. Obstetrics and Gynecology, 115(4): 839–855.
How this information was developed to help you make better health decisions.