Vaginal Oestrogen for Women

Vaginal oestrogen is a low-dose form of oestrogen applied directly to the vagina. It’s used to treat symptoms of genitourinary syndrome of menopause (GSM):

• Vaginal dryness
• Discomfort during sex
• Recurrent urinary infections

Unlike systemic HRT, vaginal oestrogen stays local and doesn’t significantly affect overall hormone levels.

Vaginal dryness can cause:

• A dry, itchy, or sore sensation in the vagina
• Discomfort or pain during sex
• Increased sensitivity or irritation
• Light bleeding after intercourse
• A feeling of tightness
• More frequent urinary tract infections (UTIs)

Vaginal atrophy is the thinning, drying, and inflammation of the vaginal tissues due to a drop in oestrogen levels after menopause. It’s part of a wider condition called genitourinary syndrome of menopause (GSM), which affects both vaginal and urinary health. Symptoms include:

• Vaginal dryness, irritation, or burning
• Pain or discomfort during sex
• Increased risk of vaginal or urinary infections
• Urinary urgency or frequency
• A feeling of pressure or discomfort in the vaginal area

Oestrogen helps maintain the thickness, elasticity, and moisture of the vaginal and urinary tissues. When oestrogen levels drop after menopause, these tissues become thinner, drier, and more prone to irritation, leading to the symptoms of vaginal atrophy.

Topical vaginal oestrogen refers to any form of low-dose oestrogen applied directly to the vaginal area. This includes creams, pessaries, vaginal tablets, and vaginal rings. It works locally to relieve dryness, discomfort, and urinary symptoms.

No, vaginal oestrogen does not cause weight gain. Because it is a low-dose, local treatment, it does not affect the body’s metabolism in the way systemic HRT might.

Yes, estriol cream (such as Ovestin) can be used externally around the vaginal opening and vulva to relieve irritation, soreness, and discomfort. This is particularly helpful for women who experience sensitivity in these areas.

Some women prefer pessaries (such as Vagifem or Imvaggis) because they are:

• Mess-free compared to creams
• Pre-measured, ensuring the correct dose
• Easy to insert with an applicator
• Less likely to cause leakage than creams

However, creams can be better for treating external soreness around the vaginal opening, so the choice depends on your symptoms and preference.