Estrogen cream is a medication for localized symptoms of declining estrogen, particularly during and after menopause. It delivers estrogen directly to specific tissues to restore health and alleviate discomfort. The cream focuses on providing symptomatic relief rather than treating body-wide hormonal imbalances.
Main Application Site
Estrogen cream is primarily applied to the vaginal area to treat symptoms of vulvovaginal atrophy, such as:
Dryness
Itching
Burning
Painful intercourse
These symptoms occur when declining estrogen levels during menopause lead to thinning and reduced lubrication of vaginal tissues. Applying the cream allows estrogen to act locally, improving tissue thickness and elasticity.
The cream also targets the urethral area, the small opening above the vagina where urine exits. Estrogen receptors are located both inside the vagina and around the urethral opening, making these areas responsive. Local application helps normalize the vaginal environment and can reduce the risk of urinary tract infections and symptoms like urinary urgency. The goal is to address discomfort where estrogen receptors are most concentrated.
Applying the Cream
Most estrogen creams come with an applicator designed to measure and insert the correct dose into the vagina. To use it, press the plunger down and screw the open end onto the cream tube. Gently squeeze the tube to fill the applicator to the prescribed dosage line.
After filling, unscrew the applicator from the tube. For insertion, lie on your back with knees bent and apart. Insert the applicator into the vagina as far as comfortable, then press the plunger to release the cream.
If the applicator is uncomfortable, finger application is an alternative. Measure the cream with the applicator, then squeeze it onto a clean finger. A pea-sized amount, roughly enough to cover half an index finger, is often suggested. Spread this amount carefully into the vaginal and urethral area, covering the vaginal opening and just inside.
Dosage and Schedule
The specific dosage and application schedule for estrogen cream are determined by a healthcare provider. Treatment often begins with a higher frequency for an initial period. For example, a common starting regimen might involve applying the cream once daily for one to two weeks.
Following this initial phase, the frequency is typically reduced to a maintenance dose, such as two to four times per week. This helps prevent symptoms from returning once the vaginal mucosa has improved. Applying the cream at bedtime is often recommended to optimize absorption and minimize leakage.
If a dose is missed, apply it as soon as remembered. However, if it is almost time for the next scheduled dose, skip the missed dose to avoid applying a double dose. Consistency in following the prescribed schedule is important for effective symptom management.
General Safety and Care
Proper hygiene is essential when using estrogen cream.
Wash hands thoroughly with soap and water before and after each application.
Avoid applying the cream to broken, cut, or irritated skin.
If cream gets into eyes, rinse immediately with large amounts of tap water.
Store the cream at room temperature (15-30°C / 59-86°F), protected from heat or freezing.
Keep it out of reach of children and pets.
Discard any unused medication after its expiration date.
Discuss any concerns or side effects with a healthcare provider, especially if symptoms do not improve or new issues arise. While local vaginal estrogen cream typically has minimal systemic absorption, certain health conditions require careful consideration. Inform your healthcare provider about any unusual vaginal bleeding, a history of certain cancers, or other existing medical conditions.