How effective is vaginal oestrogen therapy for menopause?

Menopause-related oestrogen changes can make vaginal tissue thinner, drier and more sensitive. Local oestrogen may improve moisture, flexibility and comfort over time. It is aimed at symptoms in the vagina and nearby urinary tissues, so it is not a general treatment for hot flushes, sleep changes or mood symptoms. Response differs between people, and a different product or additional treatment may be needed if symptoms continue.

Discuss your symptoms and medical history before choosing a formulation such as a cream, tablet, gel or ring. Follow the instructions and give the treatment time to work. Use a lubricant for sex if friction is painful, and consider a moisturiser for regular dryness. Do not use unexplained bleeding as a reason to self-treat; arrange an assessment first. Mention hormone-sensitive cancer, breast problems, clotting history and current medicines.

Contact a clinician about bleeding after menopause, persistent pelvic pain, a new lump or sore, unusual discharge, blood in urine or symptoms that worsen. Fever, severe pain, inability to pass urine or heavy bleeding needs urgent assessment. Vaginal symptoms can have causes other than menopause, including infection or skin conditions.

Ask whether your symptoms are likely to respond to local oestrogen, which formulation suits you, and when to review the treatment. Check how to manage missed doses, irritation or bleeding, and whether you need an examination or another test.