Sexual Health: Vaginal Estrogen & Moisturizers

Vaginal estrogen and vaginal moisturizers are used to treat symptoms in the vagina and/or vulvar area such as dryness, itching, irritation, inflammation, and improve tissue quality. These options can be helpful for people who have pain with sexual activity, are postpartum, breastfeeding, perimenopausal, menopausal, or anyone with vaginal dryness.

Low-Dose Vaginal Estradiol (Estrogen): vaginal estrogen comes in various forms: in a cream that can be inserted inside of the vagina or externally on the vestibule area, a tablet or softgel that is inserted in the vagina, or a ring inserted in the vagina.

Vaginal estrogen delivers estrogen directly to the vaginal tissue with minimal absorption to the rest of the body and restores thickness and elasticity to the vaginal lining. Because vaginal estrogen is minimally absorbed into the bloodstream (low-dose does not increase systemic estrogen levels) it is safe to use with most people, even those with a history of breast cancer.

Vaginal estrogen is different than HRT (hormonal replacement therapy) /MHT (menopausal hormonal therapy) and can help prevent urinary tract infections (UTIs) in postmenopausal women by reducing the vaginal pH. All vaginal estrogen products require a prescription from a prescribing medical provider so talk with your provider about the best option for you.

Estrace/Premarin or Estradiol Vaginal Cream 0.01% (generic)

  • 0.5-1 gram nightly for 2 weeks, then twice weekly. Can be applied with an applicator or your finger

  • Pros: can be very helpful for vaginal, vulvar, urethra, or urinary symptoms because you can apply the cream to specific areas in need: vaginal, vaginal opening, vestibule, area around the urethra, etc. This form of vaginal estrogen tends to be the least expensive.

vaginal estradiol cream menopause dryness pelvic floor physical therapy Bethany Hansen

Vagifem/Yuvafem tablet (10 mcg dose)

  • Insert the tablet nightly for 2 weeks and then twice weekly

  • Pros: Ease of use, less mess, preloaded single-use applicators

  • Cost compare with other forms of vaginal estrogen

Imvexxy: Estradiol softgel insert (4 and 10 mcg doses)

  • Ease of use, less mess, and you don’t have to clean an applicator, less plastic waste

  • Cost compare with other forms of vaginal estrogen (no generic form available)

Estring: ring (7.5 mcg/day)

  • Place one ring in the vagina and change every 3 months

  • Prose: Ease of use, don’t have to think about using it as often

Vaginal moisturizers are used to treat vaginal dryness and improve tissue quality. They are absorbed into the vaginal tissue and can improve tissue elasticity, pliability, and integrity. Vaginal moisturizers are hormone-free and contain varying ingredients, so be sure to check the label if you have sensitivities/allergies.

vaginal moisturizer suppositories menopause dryness pelvic floor physical therapy Bethany Hansen

Internal Vaginal Moisturizers: most brands have hyaluronic acid, which is a cell regenerator and can help with inflammation. They come in a suppository or gel form (with an applicator). Dose: typically 2-3x/week. Here are some product examples:

Pacific Roots Vaginal Dryness Moisturizer Suppositories: 30mg CBD, 5mg hyaluronic acid

Revaree Suppositories: 5 mg hyaluronic acid

HyaloGyn Vaginal Moisturizing Suppositories or Gel: Hydeal-D 0.2% hyaluronic acid derivative

BioNourish Ultra Moisturizing Vaginal Gel (Good Clean Love brand): contains hyaluronic acid; used with an applicator or by hand

Vulvar Moisturizers (external): These can help calm and soothe dry, irritated skin and typically contain hyaluronic acid and other ingredients to promote hydration. Dose: Apply to the vulvar region (labia major, minora, vestibule area) daily as needed.

  • Kindra V Relif Serum: sensitive skin formula; for intimacy, apply externally 30 minutes beforehand to moisturize & hydrate intimate skin

  • Kindra Daily V Lotion: thicker formula; for intimacy, apply externally 30 minutes beforehand to moisturize & hydrate intimate skin

Please Note: These self-care suggestions are for general use only and are not intended to be used as medical advice, diagnosis, or treatment. Refer to your medical provider for all questions and concerns regarding your care.

Do you need help with your sexual health and want to work with me? If you live in the greater Minneapolis, Minnesota area, my clinic is in Edina, MN - let’s work together! Contact me to learn more.