How does vaginal oestrogen therapy work?

After menopause or other changes in hormone levels, the vaginal lining may become thinner and drier. This can cause burning, irritation, soreness, pain during sex or urinary discomfort. Local treatment uses oestradiol in a form placed in or around the vagina, such as a cream, tablet or ring. The hormone acts mainly on nearby tissue, where it supports moisture, elasticity and natural lubrication. It may also help the tissues around the urethra feel less irritated. Improvement is gradual, so symptoms may not change immediately.

This treatment is different from hormone treatment taken to affect the whole body. It is intended for local genital or urinary symptoms, including symptoms associated with genitourinary syndrome of menopause. It does not treat every cause of vaginal discomfort, so unusual discharge, sores or persistent bleeding need assessment.

Use the product exactly as prescribed, including where to apply it and how often. Wash your hands before and after application, and follow the product instructions if an applicator is supplied. Do not add extra doses because relief is taking time. A clinician or pharmacist can explain whether a moisturiser or lubricant may be useful alongside treatment, especially for sex-related discomfort. Tell them about unexplained bleeding, a history of hormone-sensitive cancer, blood clots, liver disease or medicines you take before starting.

Arrange medical advice for bleeding after menopause, bleeding that starts after treatment, new pelvic pain, a breast change or symptoms that do not improve as expected. Seek prompt care for heavy bleeding, severe pain, fever, faintness or difficulty passing urine. Repeated urinary symptoms should be checked rather than assumed to be caused by low oestrogen, because infection and other conditions can need different treatment.

Ask which formulation suits your symptoms, when improvement should be reviewed, and what to do if you miss an application. You can also ask whether ongoing treatment is appropriate for you and which symptoms should trigger an examination.