The Use of Vaginal Estrogen Therapy in the Postmenopausal Woman Pt 2

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So how does vaginal oestrogen work?

Local application of vaginal oestrogen not only carries less risk than systemic HRT but it has many positive  effects!

For example, studies show it improves the number of blood vessels around the urethra and bladder neck region. This, in turn, reduces the frequency and amplitude of bladder contractions, which reduces urinary urgency. No more rushing to the loo!

It also helps to helps to alleviate recurrent urinary tract infections (UTI) as it restores the microbiota inside the vagina to a pre-menopausal state. This good bacteria acts as a bacterial buffer between the anus and urethra, which helps prevent UTIs!

Studies also show that vaginal estrogen improves vaginal blood flow, lubrication and even sensation, which can help with uncomfortable sexual symptoms.

When should vaginal oestrogen NOT be prescribed? 

Exceptions in prescription need to be considered in those women who:

  • have a history of endometrial, breast or ovarian cancer
  • have genetic risk for estrogen-dependent cancer
  • are undergoing treatment for oestrogen-dependent cancers

For these women, non-hormonal treatments (eg vaginal moisturisers) should be first-line management before any consideration of hormone replacement.

So how do I use vaginal oestrogen? 

Vaginal estrogen is produced in cream, pellet/pessary or ring form with little difference in efficacy between these forms of treatment.

The cream and pessary are often prescribed to be used daily for 2 weeks then twice a week thereafter. It is at the discretion of the treating practitioner as to when the patient must stop using vaginal estrogen therapy.

If you think vaginal estrogen is a therapy that you would benefit from, discuss this with your local GP, or come in to Sycamore Health and discover more tips from Rachel.

Are you ready to break free of your pain?

Rachel has appointments available for you today. If you believe you are experiencing any of the issues discussed in the blog, don't wait any longer to be free of your discomfort. Book now and begin to heal!

Committee Opinion No. 659 (2016) The Use of Vaginal Estrogen in Women With a History of Estrogen-Dependent Breast Cancer. Obstet Gynecol, March 2016. doi: 10.1097/AOG.0000000000001351. (2017). Position statement: The 2017 hormone therapy position statement of The North American Menopause Society. [online] Available at: [Accessed 24 Jul. 2018].
Perrotta C, Aznar M, Mejia R, Albert X, Ng CW. (2008) Oestrogens for preventing recurrent urinary tract infection in postmenopausal women. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD005131. DOI: 10.1002/14651858.CD005131.pub2

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