Vaginal estrogen is a topical application of the hormone estrogen. It may be prescribed to women to alleviate vaginal dryness or burning, as well as difficult or painful urination. Vaginal estrogen can also treat pain during sexual intercourse and soreness or itching of the vulva. The hormone is absorbed into the bloodstream and encourages collagen production to help rebuild a woman's vaginal lining.
This medication is available as a cream, a suppository, and a vaginal ring or insert. Each woman's dosage may not remain consistent. For example, a doctor will typically instruct the patient to apply the cream for the first three weeks, discontinue use for the fourth week, and then resume treatment. He may also reduce the dosage after the first few weeks of treatment. Patients who use a vaginal ring will usually leave it inserted for three months, after which a new ring may be prescribed if additional treatment is needed.
Regular doctor visits are essential for women using vaginal estrogen to help detect any possible problems. Patients should have regular pelvic exams and the doctor may recommend a mammogram in some cases. Taking estrogen can increase a woman's risk of endometrial cancer, particularly when it is used on a long-term basis. Some women may be prescribed progestin to take along with estrogen to lower the risk of this type of cancer; however, both estrogen and a combination of estrogen and progestin may increase the risk of stroke, heart attack, and breast cancer.
While using vaginal estrogen, patients should report any persistent or troublesome side effects to the prescribing physician, such as dizziness, nausea, and vomiting. Breast pain, insomnia, and irritability have also been known to occur. Some women experience changes in libido, vaginal discharge, and vaginal swelling or irritation. Cold or flu symptoms, problems wearing contacts, and unusual, darkened pigmentation on the face may also occur.
Patients should seek immediate medical attention for severe symptoms, such as problems swallowing or breathing, involuntary muscle movements, and swelling. Joint pain may occur, along with jaundice, bulging eyes, and general weakness. Some women have reported loss of appetite, pain or swelling of the stomach, and a rash.
Before using vaginal estrogen, patients should ask their doctors about all special precautions they should take, including refraining from sexual intercourse for a period of time after application. Certain dietary modifications may be considered, including avoiding grapefruit and grapefruit products. Vaginal estrogen should never be used while pregnant. Patients must disclose their other medical conditions, medications, and supplements before using vaginal estrogen.