It's not "just" vaginal dryness.

I’m assuming I will get dementia anyway like my grandmother and mother . Neither of them took any hormones ever.
We just aren’t supposed to live as long as we do.

HRT has also been linked to Dementia. We go thru menopause because we are not suppose to make estrogen anymore. I can see that oral may cause cancer before a cream. I went off the pill at 35 because of precautions. But I was on a progesterone based not estrogen. I could not take estrogen. It caused me to have intestinal pain. One reason I did not do HRT. I lucked out, no hot flashes. Just warm ones.

Moondancer mentioned there are vaginal tabs. I just want to clarity that when I said they worry about blood clots as we get older from pills , I meant oral pills.

I went off the patch at 55. Years and years ago my GYN warned me about vaginal atrophy as I aged (I'm almost 81) and I have been using vaginal estrogen since I was 55.

Vagifem 10 mcg tabs 2X a week --inserted vaginally. Studies show a low amount of estrogen absorbed into the bloodstream.

Several generics exist- Yuvafem, plain old estradiol vaginal inserts, etc. Cheapest I have found is CostPlus drugs. One can also use estrase cream and inserted vaginally but it's quite messy and not that much cheaper.

Thanks Alva. I will bring this up at my early physical.

I had severe painful endometriosis . I had a total hysterectomy (uterus, ovaries and cervix removed ) at 38 years old. I’ve been on an estrogen patch for 20 years to prevent osteoporosis . Since I’ve been over 50 , Every year I keep getting told from GYN , we will stop the patch in a couple of years . Last time I went she said we will wean you off of it at 60 years old. It will be interesting what she says this year and next year. As you get older they worry about stroke , blood clots in legs with a patch , even more so in pill form . Years ago I had already decided I would ask for the cream when my patch gets taken away from me. My friend has been using the cream for 6-7 years , she is now 69, raves it makes a difference . The cream won’t prevent osteoporosis but it’s beneficial locally . And don’t forget to do your Kegel exercises ladies , while standing on line . Lol

I ended up with a stage 3 out of four bladder prolapse because of docs putting me off of the need for HRT. This was at age 57.

The surgery to fix it resulted in 2 different hospitalizations from complications.

The thinking now is that topical HRT can make a HUGE difference with few risks. I’m now on a patch and a vaginal suppository.

Thanks for sharing, Barb. This info needs to get out there.

JoAnn, they used to refuse estrogen of any type, including cream to those of us who are breast cancer survivors. The feeling now is that topical is very little absorbed. Some cancers, ERnegative for instance, don't even make much use of estrogen for their growth. Thing is that the miniscule risk here to me would be so worth it to avoid the tragedy of constant UTIs. I used to get them more than a decade ago. While they threatened me with daily antibiotic prophylaxis they refused hormonal treatment of any kind. I was one of the lucky ones for whom the supplement D-Mannose worked and I haven't had UTI in many years. But for many the application of miniscule amounts of estrogen cream to the vulva is all it takes to work. I think this is such important information. It seems recent studies show that creams and topicals have no effect on raising estrogen levels in the blood.

Very helpful article - thanks for posting, Barb!

Great to know it also comes in pill form so that facilities don't have a reason to not prescribe it to those who tolerate taking oral meds. I wonder if they'd ever come up with a patch...?

I had a problem a few years back. So bad I went to the ER. I was told there was nothing they could really do. My GYN said the same thing. He gave me some sample estrogen cream and said use it sparingly.

I always wondered if using estrogen based cream would cause cancer. Breast is mentioned but not cervical or ovary. I know that hormone replacement therapy can contribute to cancer. I never needed it.

Barb, this is EXCELLENT short article and information. I have a friend who kept feeling like she had frequency and urgency and a burning sensation that made her certain she had UTI and was testing negative over and over. Quite desperate. Finally one smart doc realized likely urethritis from the shrinking membranes post menopause. The cream changed everything for her. She had been really quite desperate going to doc saying she had an infection and always coming up negative.

Interesting information. It brings to mind my good friend's mom who apparently is so uncomfortable "down there" she isn't able to sit still in her wheelchair. But the problem is most of these options are going to be a tough sell for a woman in the nursing home because they are applied vaginally and nobody wants to go there, I've even heard horror stories about women with untreated severe prolapse :(