What to expect from vaginal oestrogen therapy for menopause

Menopause-related oestrogen changes can make vaginal and vulval tissues thinner, drier, and more easily irritated. A prescribed cream, tablet, pessary, or ring places oestrogen near these tissues. Your clinician will show you the application method and give a starting schedule followed by ongoing use if it helps.

You may notice less dryness, itching, soreness, or pain with sex over time. Urgency or stinging with urination may also improve when nearby tissues are less irritated. Local treatment does not necessarily address hot flushes, sleep changes, or other whole-body menopause symptoms, so mention those separately.

Use the product exactly as prescribed and ask what to do if you miss an application. Wash your hands, use an applicator as instructed, and follow storage directions. A plain vaginal moisturiser can help between treatments, while a lubricant may reduce friction during sex. Avoid perfumed washes and products that sting.

Give your clinician a clear update after the planned review: describe comfort, sexual symptoms, urinary changes, discharge, irritation, and any bleeding. Do not stop and restart repeatedly without advice, because the plan may need adjusting to your symptoms and medical history.

Arrange medical advice for new or ongoing bleeding after menopause, persistent pain, a new breast change, or irritation that does not settle. Seek prompt care for heavy bleeding, severe pelvic pain, fever with feeling unwell, or difficulty passing urine. Urinary burning can be caused by infection as well as tissue irritation, so it may need testing.

Ask which local formulation fits your symptoms, when improvement should be reviewed, and how long maintenance treatment may continue. Ask whether your personal history affects its use and what to do if bleeding, irritation, or urinary symptoms appear.