Question 1

What is Estradiol Vaginal Cream used for?

Accepted Answer

Vaginal estradiol is FDA approved to treat genitourinary syndrome of menopause which includes vaginal dryness, itching and burning, painful sex, vulvar irritation, frequent urination, and/or recurrent UTIs. As women and people with vaginas age the decline in estrogen from the ovaries causes the lining of the vagina to lose elasticity, become more dry, and thin the skin, which contributes to these symptoms.
Frequently in the postpartum period, many women and people with vaginas find that they struggle with vaginal dryness as well, due to the lower levels of estrogen, especially with breastfeeding. Vaginal estrogen can help to increase lubrication during this period.

Question 2

Is hormone therapy safe?

Accepted Answer

Vaginal estrogen cream has been around and approved by the FDA since the 1980s. There is very little absorption from the vaginal tissues systemically which has fewer risks, so this is a great option for people who have health conditions that prevent them from taking oral estrogen.

Question 3

Does Estradiol Cream increase my risk of cancer?

Accepted Answer

While circulating estrogen can increase the risk of breast and endometrial cancers, applying estrogen directly to the vagina allows for a lower overall dose, which means circulating blood levels of the hormone aren't raised significantly, so breast and endometrial tissues are less exposed. Results of [recent research](https://pubmed.ncbi.nlm.nih.gov/30562320/) showed that using vaginal estrogen was not associated with a higher risk of cardiovascular disease or cancer.

Question 4

Do I have to stop taking hormones after a certain period of time?

Accepted Answer

There are recommendations by several professional organizations, including the North American Menopause Society, recommending not to start systemic hormone therapy if you are over 10 years from your last menstrual cycle or over the age of 60. However, vaginal estrogen is a considerably much lower dosage than patches or oral preparations due to being topical, therefore very little is absorbed systemically so it is safe to start this formulary at any age for treatment of menopausal vaginal concerns. Additionally, another professional organization, The American Congress of Obstetricians and Gynecologists, recommends against routine discontinuation of systemic or topical hormone therapies over the age of 65 for management of menopausal symptoms.

Question 5

What can I expect after using the product?

Accepted Answer

You will use your product nightly for 2 weeks to replenish estrogen in the vaginal tissues and then will switch to using it nightly twice a week for maintenance. You can note improvement in symptoms such as painful intercourse, vaginal dryness, vulvar irritation, itching, and burning, and reduction in UTIs and UTI symptoms such as urinary frequency. You will see the peak benefits from this treatment at 12 weeks.

Question 6

What side effects may I experience?

Accepted Answer

Common side effects with starting vaginal estrogen can include: vaginal discharge, vulvar irritation, abdominal discomfort, nausea or vomiting, headache, and breast pain. You should notify your provider if you experience any concerning symptoms such as postmenopausal bleeding, severe allergic reaction, visual disturbances, weakness or numbness of your extremities, chest pain, or any other concerning symptoms.

Question 7

What information do I need to provide after placing my order?

Accepted Answer

Patients need to provide the following so our providers can verify that treatments will be safe and effective:
A current/valid form of ID
Height and weight
A list of current medications
A list of any drug allergies
A list of current diagnoses or conditions for taking prescriptive medications
For hormonal treatments, patients may need to provide:
Blood pressure readings taken within the last year (required for combination birth control pills)
The date of your last menstrual period
_Disclaimer: Additional lab and/or diagnostics (like photos) may be required based on treatment request_

Estradiol Vaginal Cream