Clinical Information
Use as directed by your healthcare provider. If you forget a dose, apply it as soon as you remember unless it is almost time for your next scheduled dose. Do not apply two doses at the same time. Your provider will tell you the right amount and how often to use the cream.
Estradiol is a natural estrogen hormone. When applied inside the vagina, it is absorbed into the local tissues where it raises estrogen levels that have dropped after menopause. Higher estrogen makes the vaginal lining thicker, more elastic, and better able to hold moisture. Vitamin E is an antioxidant that soothes irritated tissue and supports healing. Most users feel less dryness and discomfort within 1–2 weeks, but full benefits can take up to 8 weeks. Relief usually lasts as long as the cream is used regularly.
Do not use if you are pregnant or planning to become pregnant (may harm an unborn baby). Do not use if you are breastfeeding unless your provider approves. Do not use if you have or have ever had breast cancer, uterine cancer, or any estrogen-dependent tumor (estrogen can feed these cancers). Do not use if you have unexplained vaginal bleeding, active blood clots (deep vein thrombosis, pulmonary embolism), a history of stroke or heart attack related to estrogen use, or severe liver disease. Avoid if you are allergic to estradiol, vitamin E, or any component of the cream.
Tell your provider about all medicines you take. Strong inducers of liver enzymes such as rifampin, carbamazepine, or St. John’s wort may lower estrogen levels and reduce effectiveness. Blood thinners like warfarin may work differently when combined with estrogen; your doctor may check your INR more often. Using other estrogen products or phytoestrogen supplements (for example, black cohosh) at the same time can raise estrogen exposure and side-effect risk. Limit alcohol, as heavy drinking can raise estrogen levels in the blood.
Very common (affects more than 1 in 10 users): mild vaginal burning or itching during the first few uses, which often goes away within days. Common (1–10 in 100 users): breast tenderness, headache, nausea, mild swelling in hands or feet, or vaginal discharge. Uncommon (1–10 in 1,000 users): mood changes, skin rash, or spotting between periods. Rare but serious: blood clots in the legs or lungs, stroke, or allergic reaction (hives, swelling of face or throat). Seek medical help right away for chest pain, sudden shortness of breath, severe headache, or vision changes. Most local side effects improve after the first weeks or after stopping the cream.
Store at room temperature 68–77 °F (20–25 °C). Keep the tube tightly closed and protect from heat, moisture, and direct light. Do not freeze. Keep out of bathrooms and away from children or pets. The cream is stable for 180 days from the date it is compounded. Dispose of unused or expired product through a pharmacy take-back program or mix it with coffee grounds in a sealed plastic bag before throwing it in the household trash.
Frequently Asked Questions
Q:How do I apply the cream correctly?
A:Wash your hands, fill the applicator with the amount your provider prescribed, gently insert it into the vagina, and push the plunger to release the cream. Remove the applicator, wash it with warm soapy water, rinse well, and let it air-dry.
Q:When will I start to feel relief from dryness?
A:Many women notice less burning and dryness within 1–2 weeks, but it can take up to 8 weeks for full improvement. Keep using the cream as directed even if relief is slow at first.
Q:Can I use this cream if I am also on oral estrogen or patches?
A:Tell your provider about all estrogen products you use. Using multiple estrogen sources can raise your overall exposure and side-effect risk. Your provider will decide if adjustments are needed.
Q:Is it safe to have sex after applying the cream?
A:Yes, but wait at least 1 hour after application to allow the cream to absorb. A small amount of cream may transfer to your partner; this is generally not harmful, but you can use a condom if concerned.
Q:What should I do if the cream causes burning or irritation?
A:Mild stinging is common at first and usually fades. If discomfort is severe or lasts more than a few days, stop using the cream and call your provider. They may adjust the dose or suggest a different product.
Q:Do I need regular check-ups while using this medication?
A:Yes. Your provider will want to see you at least once a year, or sooner if you have side effects, to check your vaginal health and make sure the cream is still right for you.
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