How to Get Started with Using Estrogen Cream for Vulvodynia

According to Western Medicine, vulvodynia has no identifiable cause and cure. However, doctors along with those affected admit that there are several possible causes for it to flare up. And hormonal imbalance is among one of them.

If hormones happen to be one of the culprits of your pain, then topical hormonal therapy, like estrogen cream, might be an effective vulvodynia treatment option for you.

Hormones are chemical messengers in your body produced by endocrine glands. They control most of your major bodily functions and processes like development and growth, metabolism, sexual functions, reproduction, and even cognitive functions and mood.

One of the hormone-producing glands responsible for female hormonal imbalance related problems are the ovaries. They secrete estrogen, testosterone, and progesterone – the female sex hormones.

Estrogen is the primary female sex hormone that helps develop and maintain female organs, the female reproductive system, and secondary female sex characteristics.

Estrogen is extremely important in keeping the female reproductive system healthy. When the estrogen level lowers, the vaginal and vulvar world can suffer from various painful symptoms.

Low estrogen symptoms include:

• Stinging, itching and burning vulvar sensations
• Dryness and soreness of the vagina
• Increased urge to urinate
• Burning pain while urinating
• Increased number of urinary tract infections
• Pain during sexual intercourse
• Decreased vaginal lubrication

These above-mentioned symptoms (apart from being pretty identical to vulvodynia symptoms!) are usually experienced by menopausal and post-menopausal women and are called genitourinary syndrome of menopause (GSM). Because of this, medically, these women are usually a primary group to receive estrogen therapy.

Estrogen therapy also appears to be an effective vulvodynia treatment option, apart from being an effective solution for menopause symptoms.

However, women suffering from vulvodynia don’t have to undergo full hormonal therapy, as they don’t suffer from other menopausal symptoms like hot flashes and night sweats.

That is why the main product used for vulvodynia is a low-dose estrogen vaginal cream used externally (outside of the vagina).

Concentrated application speeds up hormone delivery to the affected vulvar area and reduces the possible side effects, by minimizing the absorption of the hormone in the rest of the body.

Low-dose topical estrogen cream is not used to increase systemic estrogen levels. It is used to restore the vulva’s blood flow and improves the thickness, stretchiness, and flexibility of its fragile tissues.

Some doctors believe that what truly matters is not the hormone content of the creams, but the physical barrier between the vulva and outside irritants that the creams provide. This does not seem to be true as many women who use different types of creams (not only hormonal) can definitely feel the difference in irritation level and see thickening of their skin while specifically using estrogen creams for vulvar pain.

There are two main pre-made vaginal creams available in the US that you can use for pain relief for vulvodynia:

Another available option is a custom compounding vaginal cream, made by a pharmacist based on the doctor’s orders. In these kinds of vaginal creams, the dosage of hormones varies, as they are designed to suit an individual patient’s specific needs based on blood, urine or saliva hormone tests.

Vaginal creams for vulvodynia treatment are usually prescribed to be applied topically to the vulva (outside the vagina).

The goal of hormonal topical therapy is to keep the hormone dosage to a minimum, to limit side effects, while achieving pain relief qualities.

Creams might be used daily or several times a week. The exact dosing schedule might vary based on your doctor’s recommendations and the type of product used. Especially if you are prescribed a custom compounded cream.

Pre-made creams are usually recommended to administer:

After the recommended period of time, creams should be gradually tapered off.

Sometimes you need to wait even up to 6 weeks to notice benefits.

It is believed that external and precise use of estrogen cream for vulvodynia minimizes the absorption of estrogen by the entire body, which can lessen some side effects, although, women’s individual responses may differ.

However, long-term studies on the use of low-level estrogen creams do not exist. Therefore the exact risk of the drug is unknown.

Some side effects may go away during treatment as your body adjusts to the medicine. However, each body is different and individual responses may differ.

Common side effects which can affect you when you’re starting medication, your dose is increased rapidly or it is too high, like:

Among the drugs that may interact with estrogen are:

During discontinuation of estrogen, you might experience abnormal bleeding or flow.

Additionally, after ceasing topical estrogen creams, your vulva might become less sensitive to its own hormone due to increased exposure to it, which is called the rebound effect.