Step 4: Read and complete the decision guide to learn more about your symptoms.
Your vaginal dryness can probably be relieved with estrogen, and so can other symptoms caused by atrophic vaginitis. Since you are not having hot flashes, you don't need to take estrogen as a pill. You can supplement estrogen by placing a low dose of estrogen directly into the vagina (this is sometimes called using local estrogen). Low-dose vaginal estrogen is minimally absorbed into the bloodstream, so you should not have significant health risks from vaginal estrogen. Low-dose vaginal estrogen can be continued long-term, except in women who are diagnosed with breast cancer. (In this case, vaginal estrogen is not recommended.)
Vaginal estrogen is available in several forms. It is available as a vaginal insert that is shaped like a ring, such as Estring. The ring is made of flexible silicone that slowly releases stored estrogen. It is inserted and left in place for three months at a time. A high-dose estrogen ring (Femring) is available, but this causes a significant amount of estrogen to enter the bloodstream, so its risks are similar to those of oral estrogen.
Vaginal estrogen is also available as vaginal tablets (Vagifem) that are specifically designed to be inserted into the vagina. (If you have been prescribed estrogen tablets with directions to take them orally, do not insert these into your vagina.)
Vaginal estrogen is also available as a cream (Premarin and other brands). Some women feel that the cream form of estrogen is the fastest to relieve symptoms because it provides extra lubrication.
These treatments require a prescription. Visit with your doctor if you would like to discuss local (vaginal) estrogen treatment.