A low-dose, local treatment for some of the most common — and most treatable — menopause symptoms.
The Menopause Clinic
Does this sound familiar?
You don't have to live with this
Vaginal dryness or irritation
Pain or discomfort with sex
Reduced sensation or harder to orgasm
Urinary urgency, frequency, or repeat UTIs
These are part of Genitourinary Syndrome of Menopause (GSM) — and they're caused by low estrogen in the tissue.
Why this matters
It's the most effective treatment
For these symptoms, vaginal estradiol is the most effective option there is. It restores moisture, elasticity, blood flow, and nerve function directly in the tissue that needs it. Large studies show it works well for most women.
A common misunderstanding
~40%
of women using an estrogen patch or pill still need vaginal estradiol to fully relieve vaginal and urinary symptoms. Whole-body estrogen often doesn't reach these tissues well enough on its own.
What it is
Local, not whole-body
Vaginal estradiol works directly in the vaginal and urinary tissues and does not significantly enter the bloodstream. It is not the same as hormone replacement therapy, and most women using it alone do not need progesterone.
An important point
You can use both
You can use vaginal estradiol together with a patch, gel, or pill. They do different jobs — whole-body estrogen treats hot flashes, sleep, and mood, while vaginal estradiol treats the local tissue. Using both is common and completely appropriate.
Where it goes
Treat all the right areas
The tissues that need estrogen include the vaginal opening, the lower vagina, and the vulva — especially the inner labia and the area around the urethral opening.
Your prescription
"Apply 1 gram, 3× per week"
Your prescription may read like that. Here's what 1 gram actually means in practice — you split it into two halves, applied two different ways:
0.5 g by finger — to the opening & vulva
0.5 g by applicator — into the lower vagina
First half — by finger
0.5 g on your finger
Squeeze about 0.5 g onto your fingertip (roughly the amount shown).
Apply it to the vaginal opening and the vulva — the inner labia and the tissue around the urethral opening.
Gently rub it in, like a moisturizer — it should be worked into the tissue, not just left on the surface.
Second half — by applicator
0.5 g with the applicator
Attach the applicator to the tube and squeeze cream in until it reaches the 0.5 g mark.
Gently insert the applicator into the lower vagina and press the plunger fully.
Wash your hands when you're done.
A few tips
Make it easier
Apply at bedtime to reduce leakage. A panty liner can help during the first week or two. Wash your hands before and after.
If symptoms are severe
You may start with a daily phase
For more severe symptoms, your provider may have you use it nightly for about two weeks first, then drop to a maintenance schedule. Follow the directions specific to you.
A less messy option
Vaginal tablets
If the cream works but you dislike the application, vaginal tablets (and a vaginal ring) are effective alternatives — less messy, same benefit. Let us know and we can switch you.
Before you start
Read your full guide
Before starting any medication, read its complete guide. All of your guides are in your patient portal — and we're here for any questions.
Effective treatment is available
Evidence-based menopause care
If you have any of these symptoms, message us through your patient portal.
General education only — always follow your personalized plan from The Menopause Clinic.
