The best thing to prevent vaginal atrophy is vaginal estrogen placement.
There are three ways to give local estrogen to all of the estrogen receptors in and around your vagina and bladder. A vaginal estrogen cream, a vaginal estrogen pill, or a vaginal estrogen ring are the three options at this stage.
The first option is the vaginal cream.
There are two FDA-approved vaginal creams to help build up the vaginal skin (mucosa). They are Estrace® Vaginal Cream, and Premarin® Vaginal Cream. The Estrace® Vaginal Cream is estradiol cream. It contains one estrogen: estradiol. Premarin® Vaginal Cream is what is called a conjugated estrogen cream. This means that there are several estrogens conjugated (or combined) together: estradiol, estriol, and estrone.
The second option is inserting a small tablet of estrogen into the vagina every other day.
The third option for vaginal (local) estrogen is the Estring® vaginal ring. The Estring® is approved for vaginal dryness. This is a very convenient way to give local estrogen if you don’t mind sticking your fingers in your vagina to put it in or take it out. It is very easy to use. Once the package is opened, the estrogen is delivered right to the vagina from the ring; the medication lasts for three months. At the end of three months, you take it out and put in another. You can take it out every day if you want to wash it off and you can take it out for intercourse. It is a silastic ring impregnated with estradiol. You take it out of the package, squeeze it, and push it in as high as you can. The edge can rest on your pubic bone. For those of you who used a diaphragm many years ago, you put it in your vagina exactly the same way.
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