- The FDA warning label for vaginal estrogen states that oral estrogen can cause serious health risks such as cancer, blood clots, and stroke.
- While studies have shown that this is true of oral estrogen products, vaginal estrogen is prescribed in very low doses, has minimal absorption in the bloodstream, and has not been shown to carry a risk of cancer, clot, or stroke.
- Women with vaginal atrophy can take comfort knowing that the American College of Obstetricians and Gynecologists states that vaginal estrogen is safe, and they have been lobbying the FDA to remove this label.
- Always apply your treatment before bed.
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Getting started
If this is your first time using vaginal estrogen and if you want initial results as quickly as possible, an option you can take is to apply 2 grams of cream every day for the first two weeks, then continue with 1 gram twice weekly.
Alternatively, you can go straight to 1 gram twice weekly, allowing for a little more time for initial results.
Keep in mind that each tube is about a two month supply if used twice weekly, so if you run out of your first tube faster, you can always reschedule your shipment from your account.
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Step 1Throw out the applicator. The medication I've prescribed comes with an applicator. However, the applicator can waste medication, get messy, and be uncomfortable.
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Step 2Wash your hands with soap and water and dry thoroughly.
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Step 3Squeeze the tube to dispense the medication. 0.5 grams of medication is about the length of the tip of your finger.
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Step 4Locate the vaginal opening. Immediately above the vaginal opening is the urethra (a small opening where urine is eliminated from your body). The urethra may not be as easily identified as the vagina because the opening is much smaller, however, use the diagram below to determine its approximate location.
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Step 5Carefully spread the cream into the vaginal/urethral area. As the cream is spread, make sure to cover the opening and just inside of the vagina as this is where the majority of estrogen receptors are located; however, it is not necessary to push the cream high into the vagina.
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Step 6Wash your hands and avoid touching, bathing, or wiping the area for 1-2 hours to allow the medication to absorb.
- Always apply your treatment before bed.
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Getting started
If this is your first time using vaginal estrogen and if you want initial results as quickly as possible, you can do an initiation does which is to apply 1 insert every day for the first two weeks, and then continue with 1 insert twice weekly (for example Tuesdays and Fridays).
Alternatively, you can go straight to 1 insert twice weekly, allowing for a little more time for initial results.
Each box contains 18 applications. Your refill ships automatically in 2 months, but if you run out faster on the initiation dose you can always go to your account and reschedule your refill for sooner.
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Step 1The medication I've prescribed should be administered intravaginally using the supplied applicator. Tear off a single applicator.
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Step 2Hold the applicator so that the finger of one hand can press the applicator plunger, like a tampon.
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Step 3Guide the applicator gently and comfortably through the vaginal opening. If prior to insertion the insert falls out of the applicator, throw the insert and applicator away and use a new insert-filled applicator.
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Step 4The applicator should be inserted (without forcing) as far as comfortably possible, or until half of the applicator is inside your vagina, whichever is less.
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Step 5Once the insert-filled applicator has been inserted, gently press the plunger until the plunger is fully depressed. This will eject the insert inside your vagina where it will dissolve slowly over several hours.
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Step 6After depressing the plunger, gently remove the applicator and dispose of it the same way you would a plastic tampon applicator. The applicator is of no further use and should be discarded properly. It is advisable to apply vaginal estradiol inserts before bed to allow time for the insert to dissolve. If you have any questions, please consult your healthcare provider or pharmacist.
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