Skip to main content

No woman should suffer a dry vagina! Make sure you use vaginal oestrogen correctly.


Menopause, a natural phase marking the end of reproductive years, brings about hormonal changes that can lead to a range of symptoms. Among these, vaginal dryness stands out as a common concern, causing discomfort, pain during intercourse, and an increased susceptibility to urinary tract infections. Vaginal oestrogen is an effective and targeted solution, addressing these specific symptoms without significantly impacting systemic hormone levels.


Why vaginal oestrogen?

As oestrogen levels decline, the vaginal walls may thin, dry out, and become inflamed, leading to discomfort and pain. Vaginal oestrogen works by replenishing oestrogen locally, providing relief without the broader effects associated with systemic hormone therapy. Vaginal oestrogen also positively impacts the local tissues of the urethra and bladder.


When to consider vaginal oestrogen

Any woman of any age experiencing vaginal dryness, itching, pain during intercourse, bladder irritability, urge incontinence or frequent urinary tract infections may find relief through vaginal oestrogen. There are other causes of irritation, such as infection and other skin conditions, so of treatment isn’t helping, make sure your doctor examines your skin carefully.

Women who wish to avoid or cannot use systemic hormone therapy are still usually able to vaginal oestrogen as there is very little absorption beyond the local tissues. There is no need to protect the womb lining from the effects of oestrogen by using progesterone as is the situation with systemic HRT.

Many women using systemic HRT also need vaginal oestrogen. 


How vaginal oestrogen works

Vaginal oestrogen is available in various formulations – pessaries (tablets for your vagina) and cream. Creams are applied topically to the vaginal area, offering immediate relief from dryness and discomfort. Tablets are inserted into the vagina, releasing oestrogen gradually over time. 


How to use vaginal oestrogen

Generally, a 2 week course of daily use is recommended to turbo charge the effect followed by application twice a week. This can be varied according to response.

The pessary is best used at night so any leakage as it dissolves is not annoying. Cream can be applied to skin of the vulva daily or as required.

Unlike tampons, the best location to place the pessary is on the lower part of the vagina, so the oestrogen absorbs into the front or anterior vaginal wall and through to bladder tissues as seen in the diagram. (This is also different to any progesterone you may be using for the womb that is best placed as high and backward as you can get it.)

In Australia, the 2 forms of vaginal oestrogen pessaries are called Vagifem and Ovestin Ovula. The applicator for Vagifem pessaries should NOT be inserted all the way, just 1-1.5 inches in so that the pessary lies low in the vagina. Ovestin Ovula is a larger bullet which is pushed into the vaginal opening using your finger. You can coat with water if required. It should be inserted just far enough in so that it is comfortable.

If you don’t find vaginal oestrogen is helping you, make sure you are using it correctly and see your doctor – you may also need to change the preparation or dose.


This information is for general educational purposes only and does not constitute medical advice. Please see your health professional for advice that is personalised to you.
Key Take Aways

Vaginal oestrogen can be used with or without systemic HRT.

Most women with breast cancer can use vaginal oestrogen

Regular use will treat discomfort from dryness, intercourse, bladder irritability and help prevent urinary tract infections.