Estrogen cream is a prescription topical hormone therapy. It is a local hormone therapy, meaning its effects are primarily concentrated where it is applied, with minimal absorption into the bloodstream. This medication is available only through a healthcare provider’s prescription. It comes in various formulations, including estradiol and conjugated estrogens, and is distinct from systemic hormone replacement therapies.
Understanding Estrogen Cream’s Purpose
Estrogen cream is typically prescribed to alleviate localized symptoms arising from declining estrogen levels, often associated with menopause. These symptoms include vaginal dryness, irritation, itching, painful intercourse (dyspareunia), and certain urinary issues like urgency, all linked to vulvovaginal atrophy. This condition involves the thinning, drying, and inflammation of the vaginal walls due to reduced estrogen. The cream works by restoring thickness and elasticity to the vaginal lining and normalizing the vaginal environment, which can also help decrease the risk of urinary tract infections.
Step-by-Step Application Guide
Wash your hands thoroughly before applying estrogen cream. Always read the specific instructions provided with your product, as application methods vary between brands. Most creams include a specialized applicator to measure the prescribed amount and aid insertion.
To use the applicator, press the plunger all the way down, then screw the open end onto the cream tube. Gently squeeze the tube to fill the applicator to the line indicating your prescribed dose. After filling, unscrew the applicator and replace the tube cap. For comfortable insertion, you can lie on your back with knees bent or stand in a comfortable position.
Gently insert the applicator into the vagina as far as is comfortable, then push the plunger completely to release the cream. It is not necessary to push the cream high into the vagina; spreading it to cover the vaginal and urethral areas is sufficient. Some prefer applying the cream with a clean finger after measuring the dose. After each use, wash reusable applicators with warm, soapy water and rinse thoroughly, or dispose of single-use applicators as directed. Applying the cream at bedtime can help minimize leakage.
Important Considerations Before and During Use
Before starting estrogen cream, discuss your medical history with your healthcare provider, as certain conditions may contraindicate its use. For example, individuals with a history of certain cancers, such as breast or uterine cancer, should discuss potential risks with their oncologist. Undiagnosed abnormal vaginal bleeding also requires investigation before starting treatment.
Other conditions that may preclude the use of estrogen cream include active blood clots, a history of stroke or heart attack, or liver disease. Pregnancy and breastfeeding are generally not recommended. Though systemic absorption is minimal, inform your doctor about all medications you are taking, as some interactions are possible. Estrogen cream is intended for localized symptoms and does not provide the systemic benefits or risks associated with oral hormone replacement therapy.
What to Expect and When to Consult a Doctor
Many individuals using estrogen cream begin to notice an improvement in symptoms like vaginal dryness and discomfort within one to two weeks of starting treatment. The full benefits may take longer to develop, often becoming apparent after four to twelve weeks of consistent use. Common, mild side effects can include local irritation, a slight increase in vaginal discharge, or breast tenderness. These effects are often temporary as the body adjusts to the medication.
Contact your healthcare provider immediately if you experience new vaginal bleeding after menopause or any unusual vaginal discharge or odor. Signs of more serious, though rare, side effects also warrant immediate medical attention, such as sudden chest pain or shortness of breath, severe leg pain or swelling, or changes in vision, which could indicate a blood clot. Any signs of a severe allergic reaction, such as swelling of the face, lips, or throat, or difficulty breathing, require emergency care. Regular follow-up appointments with your prescribing doctor are important to monitor your progress and ensure the treatment remains appropriate for your needs.