Vaginal Oestrogen Therapy

Vaginal oestrogen therapy places a small dose of oestrogen in vaginal tissues to ease dryness, irritation, and related urinary or sexual symptoms.

It may come as a cream, tablet, pessary, or ring, depending on the product and local prescribing practice. The medicine acts mainly where it is applied, so it is different from systemic hormone therapy used for symptoms throughout the body. A prescriber chooses the product, dose, and schedule after discussing symptoms, medical history, and examination findings.

Dryness or irritation may begin to ease during the first few weeks, although tissue comfort can take longer to build. Urinary symptoms and pain during sex may improve gradually when low-oestrogen tissue changes are contributing. Keep using the treatment as prescribed unless your clinician changes it. If symptoms do not improve, another cause may need assessment.

Local stinging, itching, discharge, breast tenderness, or light spotting can occur, particularly when treatment begins. Tell your clinician about bleeding after menopause, persistent irritation, breast changes, or symptoms that are new or worsening. Severe pain, heavy bleeding, chest pain, sudden breathlessness, or one-sided leg swelling needs urgent medical attention.

Many people need an initial daily or regular phase followed by a maintenance schedule, but the exact plan depends on the product and response. Symptoms can return when local treatment is stopped because the tissue changes may persist after menopause. Your prescriber can review whether ongoing use remains suitable and adjust the schedule if symptoms or risks change.

Local vaginal oestrogen is intended for vaginal and nearby urinary symptoms, not every menopause symptom. It can improve tissue moisture and flexibility, making sex or an examination more comfortable. It is not a treatment for an unexplained vaginal infection or bleeding. Do not share products, and use the applicator exactly as directed.

A clinician may discuss this option with people who have vaginal dryness, burning, tissue fragility, pain during sex, or urinary discomfort related to low local oestrogen. These symptoms commonly occur with [Menopause](/conditions/menopause/) and [Genitourinary Syndrome of Menopause](/conditions/genitourinary-syndrome-of-menopause/). Local treatment may also be considered for people with [Recurrent Urinary Tract Infections](/conditions/recurrent-urinary-tract-infections/), when a clinician believes tissue changes contribute.

Wash your hands, check the label and prescribed dose, and choose a private position that allows the pelvic floor to relax. Apply the cream, insert the tablet or pessary, or place the ring exactly as instructed. Wash the applicator if the product allows reuse. Some products are easier at bedtime; follow the specific instructions rather than changing the schedule yourself.

There is usually no recovery period, although a little leakage or local awareness can happen after application. A thin pad may help with cream or pessary residue. Avoid adding perfumed washes or douches, which can irritate the area. Arrange review if symptoms persist, intercourse remains painful, or discharge, itching, or bleeding does not settle.

Tell the prescriber about unexplained vaginal bleeding, a history of hormone-sensitive cancer, blood clots, liver disease, or medicines that may affect treatment decisions. The product may not be suitable for everyone. Report new bleeding rather than assuming it is a normal effect. A clinician can explain whether local therapy, another treatment, or further examination is appropriate.

Non-hormonal vaginal moisturisers can support regular moisture, while lubricants can reduce friction during sex. Pelvic-floor physiotherapy may help muscle-related pain or guarding. Treating infection, skin disease, or another pelvic condition may address symptoms more directly. [Vaginal Dryness](/symptoms/vaginal-dryness/) and [Pain During Sex](/symptoms/pain-during-sex/) provide symptom-focused context. The material used in this treatment is [Oestradiol](/materials/oestradiol/).

A gynaecologist, menopause clinician, or primary-care doctor can assess symptoms and discuss local treatment. Bring a record of bleeding, urinary symptoms, pain, previous hormone treatments, and relevant medical history. Ask how the product is applied, when follow-up is needed, and which changes require prompt review. Treatment should be chosen with your personal risks and preferences in view.