Many women are concerned about using estrogen for relief of menopausal symptoms, due to all of the negative press that estrogen has received. But there is a difference in safety and side effect profile based on how the estrogen is used. If your symptoms are mostly related to dryness and painful intercourse (vaginal atrophy) then using local estrogens may bring you relief with little to no side effects. Local estrogens (in ring, pill or cream form) are estrogens that are used in very low doses in the vagina. They work by restoring the vaginal pH, as well as thickening the vaginal epithelium. Because the hormone works locally, absorbed through the vaginal walls, it does not typically increase estrogen levels in the blood. Studies have shown that it does not increase your risk for endometrial cancer. So it can be a safe, effective way to relieve the symptoms of postmenopausal vaginal atrophy.
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