Use of Estrogen Cream After Menopause

The use of estrogen cream after menopause can help treat some of the uncomfortable symptoms many women experience. The cream is easy to use and well tolerated by most patients, but there are risks and side effects to consider. Estrogen cream is sold under the brand name Premarin and requires a prescription. There is no generic available.

The Facts

• Conjugated vaginal estrogen cream, or simply estrogen cream, contains several estrogen related compounds. The exact mixture of the chemicals used in estrogen cream is actually unknown, but doctors do know the cream contains estrogen, 17 alpha dihydroequilin and equilin. The materials themselves are taken from the urine of pregnant horses.

  Vaginal cream helps increase thickness of the vaginal lining and helps to ease vaginal dryness after menopause. The cream can also reverse any atrophy that has occurred in the vaginal lining.

Usage

• Vaginal cream is administered directly into the vagina using an applicator. The patient fills the applicator with their prescribed dose of cream, lays back with knees bent and relaxed, inserts the applicator into the vagina and uses the plunger on the applicator to administer the dose. Most women use the cream daily, and doctors recommend that the dose be given at night time, just before bed.

  If there is irritation on the vulvae, the cream can be rubbed by hand in this area as well.

Side Effects

• There are a number of side effects associated with vaginal cream. Bleeding is the most common concern, but breast tenderness, changes in sexual arousal, migraine headaches, bloating and mood swings are also possible. High doses of estrogen may cause gallstones that require surgery for removal. Some women become unable to wear their contact lenses as estrogen can increase the curve of the cornea. Brown skin patches on the face, especially the forehead and cheeks, may also appear. These patches, called melasma, may be permanent.

Risks

• High levels of estrogen put women at risk for blood clots. Smoking increases these risks. Doctors recommend you quit smoking before using estrogen cream.

  There is an increased risk of endometrial cancer for women on estrogen cream. Although these cancers tend to be less aggressive when women are on estrogen treatment, your doctor can reduce the risk by adding progestin to your post menopausal treatment plan.

  Although the data is unclear, the risk of breast cancer may increase when using estrogen cream.

Getting Help

• Menopause may be difficult to deal with, but your doctor can help you cope with symptoms. If you are experiencing vaginal dryness and irritation after menopause, be sure to speak to your doctor. She can help you decide if estrogen cream is the right choice for you.