28/08/2024 | Press release | Distributed by Public on 28/08/2024 17:19
Key takeaways:
Estradiol vaginal cream (Estrace) helps treat vaginal and urinary symptoms related to menopause. It's best to apply it using the included applicator. But you can also use your finger if the applicator is difficult or painful for you.
Estradiol vaginal cream can take 2 to 3 months to reach its full effect. It may cause some leakage and vaginal irritation for some people. While rare, you may experience breast pain when you start using it. But estradiol vaginal cream isn't linked to serious side effects, such as blood clots or breast cancer.
Estradiol vaginal cream doesn't treat menopause symptoms like hot flashes or night sweats. But you can combine it with systemic forms of estrogen (such as pills or patches) if needed to help manage these symptoms.
Estradiol vaginal cream is available as a lower-cost generic. GoodRx can help make your prescription more affordable with a free discount.
From hot flashes to vaginal dryness, the body undergoes a lot of changes during menopause. These changes are due to a drop in the levels of two hormones - estrogen and progesterone. Fortunately, hormone replacement therapy (HRT) can help manage many menopausal symptoms.
Estradiol vaginal cream (Estrace) is one type of HRT. It helps treat vulvar and vaginal dryness and painful sex caused by menopause. Estradiol vaginal cream may also help with urinary urgency and frequency, which reduces the risk of urinary tract infections.
But what's the best way to apply estradiol vaginal cream? Do you need to use the applicator, or can you just use your finger? Here, we'll cover six tips for using estradiol vaginal cream to help you get the most from your medication.
Vaginal dryness? Learn which over-the-counter and prescription treatments work best.
Hormone treatment for perimenopause: Here are the risks and benefits of hormone treatment for perimenopause symptoms.
Estrogen supplements guide: From patches and pills to vaginal creams and rings, we cover the different types of estrogen supplements and how they compare.
Vaginal estradiol cream comes with a reusable applicator to help you measure and insert your dose. Here are the steps for using it:
Press the plunger end of the applicator all the way down.
Screw the open end of the applicator onto the open end of your tube of vaginal cream.
Gently squeeze the tube so the cream fills the applicator.
The plunger has lines marking 1 g to 4 g of cream. Stop squeezing when it reaches the line for your recommended dose.
Unscrew the applicator from the tube of vaginal cream and put the cap back on the tube.
Insert the applicator into the vagina as far as is comfortable and press down on the plunger.
Remove the applicator and wash it with soap and warm water.
Using the applicator helps ensure you're measuring the correct dose of estradiol cream. It also helps reduce the risk of contamination, since the cream goes directly from the tube into the applicator.
Using a finger to apply the cream may be appropriate in some cases, according to Dr. Stephanie Faubion, Director of the Mayo Clinic Center for Women's Health and Medical Director for The Menopause Society.
"I often recommend that women simply use their finger to apply the estrogen cream…because the applicator can sometimes be challenging to use and may cause discomfort for some women with more severe symptoms," said Faubion.
I often recommend that women simply use their finger to apply the estrogen cream… the applicator can sometimes be challenging to use and may cause discomfort for some women.
- Dr. Stephanie Faubion
To do this, Faubion suggests measuring your dose using the applicator. Then, squeeze the cream from the applicator onto a finger. This helps you to see how much cream is needed for each dose. You can then use your finger to insert the cream inside your vagina. Faubion also recommends applying a small amount of cream to the vulva (external genital area) as well, since dryness symptoms can affect this area too. Be sure to wash your hands with soap and water before and after using this method.
If you're having trouble or discomfort using the applicator, talk to your prescriber about using the finger method instead.
You may notice some leakage after inserting estradiol vaginal cream. This is normal, and shouldn't affect how well the medication works.
Lying down for a few minutes after administering your dose or inserting it at bedtime may help reduce leakage. Don't use a tampon or other vaginal products to try to keep the cream in place. But it's a good idea to wear a sanitary pad or pantyliner to protect your clothing.
It can take time for vaginal estradiol cream to start working. "Women won't have the full effect of the vaginal estrogen cream for 2 to 3 months," said Faubian. "Also, it must be used long-term because the symptoms will recur when it is discontinued."
In the meantime, Faubion recommends that to alleviate dryness and discomfort, "women can and should still use a lubricant as needed for sexual activity."
The estrogen in vaginal estradiol cream mainly works in the area where it's applied. It isn't well-absorbed into the bloodstream. So it won't help with full-body menopause symptoms, like hot flashes and night sweats. These symptoms require treatment with estrogen that's absorbed into the bloodstream (systemic forms of estrogen). This includes oral tablets and topical patches or gels.
In some cases, you may need a combination of vaginal and systemic estrogen to manage your symptoms. Faubion confirms, "Yes, you can use low-dose vaginal estrogen cream in addition to systemic estrogen (such as a pill, patch, gel or spray), and sometimes it is necessary to adequately address the genitourinary symptoms. For some women, and especially those who are using lower systemic doses, the systemic estrogen is insufficient to manage the genitourinary symptoms."
Keep in mind that there are different risks with systemic estrogen treatments than with estradiol vaginal cream. And if you have a uterus, you'll need to take a progestin along with a systemic estrogen. Be sure to discuss the risks and benefits of the different types of HRT with your prescriber.
Most estradiol vaginal cream side effects are related to the area where you apply it. This includes:
Vaginal discharge
Vaginal bleeding
Vaginal burning or irritation
Faubion explains that "Low-dose vaginal estrogen is minimally absorbed and has not been linked with adverse events such as blood clot, heart attack or breast cancer." However, she says rarely, some people notice breast pain when they start using the cream. She also recommends that if vaginal bleeding occurs, you should contact your prescriber. Vaginal bleeding after menopause could be linked to a serious health problem and should be evaluated.
Estradiol vaginal cream (Estrace) is available as both a brand-name medication and a lower-cost generic. Generic estradiol cream's price at certain pharmacies is as low as $26.05per tube with a free GoodRx discount.
Estradiol vaginal cream (Estrace) helps manage vaginal and urinary symptoms related to menopause. It's best to use the included applicator to measure and apply estradiol vaginal cream. But if it's difficult or uncomfortable for you, you can use the applicator to measure your dose, then apply it using a finger. Just be sure to wash and dry your hands before and after using this method. Keep in mind that it can take a couple of months for estradiol vaginal cream to start working.
Estradiol vaginal cream won't treat body-wide menopause symptoms, such as hot flashes or night sweats. But you can use it along with other forms of estrogen that treat those symptoms, such as tablets or patches. Vaginal estradiol cream hasn't been linked to serious side effects, such as blood clots and breast cancer. But you may experience vaginal irritation or sore breasts in some cases.
A-S Medication Solutions. (2024). Estradiol - estradiol cream [package insert].
Angelou, K., et al. (2020). The genitourinary syndrome of menopause: An overview of the recent data. Cureus.
Hosseinzadeh, P., et al. (2015). A comparative study of vaginal estrogen cream and sustained-release estradiol vaginal tablet (Vagifem) in the treatment of atrophic vaginitis in Isfahan, Iran in 2010-2012. Journal of Research in Medical Sciences.
Planned Parenthood. (n.d.). What are the parts of the female sexual anatomy?
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