Effective, targeted treatments are available that don't require systemic hormone therapy.
Local vaginal estrogen (very low systemic absorption):
- Estradiol 0.01% vaginal cream — applied daily for 2 weeks, then twice weekly
- Estradiol 10 mcg vaginal inserts — inserted daily for 2 weeks, then twice weekly
Non-hormonal options:
- Vaginal moisturizers (e.g., Replens), used 2–3 times per week
- Lubricants, for use during intercourse
If you have a personal history of breast cancer: Vaginal estrogen is not automatically off-limits, but this decision must be made with your oncologist. Do not use any estrogen-containing product after a breast cancer diagnosis without specialist guidance.