Estrogen cream is a topical medication used as a type of hormone replacement therapy (HRT) to treat conditions caused by low levels of this important female hormone. There are both prescription and over-the-counter (OTC) versions of this medication, which can be applied to the skin or inserted into the vagina. Though both are generally effective, they can have unwanted side effects both on the users and on their family members, so healthcare practitioners usually recommend that women use them for a limited amount of time in a low dosage and take care not to expose others.
Most estrogen creams are made of estradiol or estrone, or conjugated estrogens, which are a mixture of hormones similar to those found in the urine of pregnant horses. Each type can be made synthetically or from natural materials, and they come in topical and vaginal forms. Some preparations come mixed with other hormones, like progesterone, which also declines with age. Though there are some OTC versions, the vaginal ones are almost always prescription-only, as are higher-concentration topical versions.
Estrogen creams are primarily used to treat the symptoms of menopause, during which a woman's body slows down its estrogen production. This often causes uncomfortable side effects, including vaginal dryness, atrophy, and itching; urinary incontinence; and painful intercourse, all of which estrogen cream may help with. It may also help with other side effects of menopause, like mood swings and insomnia.
When used in topical form, this cream is usually just applied to the skin, but when used vaginally, it typically comes with an applicator. A woman attaches the applicator to the tube of cream and inserts it into her vagina to apply the medication. Other women prefer to just use their fingers to apply it.
A trial-and-error period is often required before an effective dose is determined, because absorption levels vary greatly from person to person. Even though estrogen creams are available without a prescription, women should work with a medical professional to find the dosage that works best for them. Regular testing is necessary to monitor hormone levels and prevent a patient from using too much. Healthcare providers typically recommend that individuals avoid applying the medication regularly to the same area of skin to reduce the likelihood of irritation and muscle wasting.
Since research shows that using the supplement twice a week is just as effective as daily doses, clinicians usually recommend using it as infrequently as possible. Healthcare providers also suggest using it in cycles so that the body experiences a resting period, and a typical monthly cycle is three weeks on and one week off. This helps the body better manage the estrogen that it absorbs from the cream.
Side Effects and Contraindications
The most common side effects from estrogen cream are light vaginal bleeding, vaginal discharge, headaches, and yeast infections. It may also cause nausea, abdominal pain, and breast pain. Since this medication is so strong, medical professionals recommend using it for as short a period as possible. Long-term use is associated with dementia, cardiovascular disease, liver problems, and uterine cancer.
Women who are pregnant or breastfeeding should not use this type of medication, and it is not suitable for those with a history of breast or uterine cancer. It can also make certain conditions worse, including asthma, diabetes, and migraines, so women with these conditions should make sure their healthcare provider knows about them. Also, estrogen can interact with several medications, including blood thinners, so women should check with a medical professional before using any products containing it.
There is conflicting data to both support and discourage the use of estrogen cream for HRT. It is effective, but it can cause muscle wasting when applied to the same area of skin regularly. When inserted in the vagina, the hormone may affect men exposed during intercourse. Men regularly exposed to estrogen cream through sexual contact can develop symptoms directly related to the hormone, such as breast enlargement. Children and pets can also develop serious side effects from coming into contact with this medication, so it's important to keep it stored safely.