Menopause is a time of huge transition. For many women the physical symptoms can be overwhelming, from hot flushes to brain fog, but one of the most common and least discussed problems is vaginal dryness and discomfort. These intimate symptoms are often whispered about, if they are spoken about at all, yet they affect millions of women across the UK.
The good news is that there is safe and effective treatment available. Vaginal oestrogen, sometimes called local or topical oestrogen, can transform quality of life for women who are struggling with dryness, irritation, painful sex or recurrent urinary infections.
In a recent live conversation, Dr Rebecca Poet, GP and menopause specialist, shared her expertise on vaginal oestrogen. She explained why it matters, what options are available, and why women should feel confident about asking for it. As she put it,
“Vaginal oestrogen is life-changing for so many women, yet it is still surrounded by stigma and misunderstanding. We need to talk about it openly.”
This guide brings together Dr Poet’s advice, expert resources, and empowering reassurance to help you understand vaginal oestrogen and feel confident in making choices about your health.
Why Vaginal Oestrogen Matters
During perimenopause and menopause, levels of oestrogen naturally fall. This hormonal shift affects tissues throughout the body, but it is particularly noticeable in the vagina and urinary tract. Without oestrogen, the vaginal walls become thinner, drier and less elastic. This can lead to symptoms such as:
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Vaginal dryness and irritation
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Pain or discomfort during sex
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Itching or burning sensations
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Urinary urgency or frequency
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Recurrent urinary tract infections
Dr Poet explained,
“So many women accept these symptoms as something they have to live with, but they are not. Vaginal oestrogen directly treats the tissues that need support and brings real relief.”
These changes are often grouped under the term Genitourinary Syndrome of Menopause (GSM). The NHS estimates that more than half of postmenopausal women experience some of these symptoms (NHS, menopause guide). Yet many never seek help.
Breaking the Taboo
Despite being common, vaginal symptoms remain under-discussed. Many women feel embarrassed to bring them up with their GP, and some doctors are not proactive in asking.
Dr Poet noted,
“Women tell me they feel silly talking about dryness or discomfort, even though it affects their daily life and relationships. We have to break that taboo. This is a medical issue with safe treatment available.”
The silence around vaginal symptoms means women often suffer unnecessarily. Some withdraw from intimacy, others endure chronic discomfort. By talking openly, women can realise they are not alone and that effective help exists.
Types of Vaginal Oestrogen
There are several ways to use vaginal oestrogen, and the best choice depends on personal preference. Options include:
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Creams – applied with an applicator inside the vagina
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Tablets or pessaries – small tablets inserted vaginally
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Oestrogen ring – a flexible ring placed in the vagina that releases oestrogen slowly over three months
Dr Poet explained,
“There is no one right choice. Some women prefer a cream because they can also apply it externally. Others like the ring because you put it in and forget about it for three months. What matters is finding what fits your life.”
All of these options provide very low-dose oestrogen directly to the vaginal tissues. This means they act locally rather than throughout the whole body.
Safety and Effectiveness
One of the biggest worries women have is whether vaginal oestrogen is safe.
Dr Poet was very clear,
“Vaginal oestrogen is not the same as HRT tablets or patches. The dose is tiny, it stays local, and it does not increase risks in the way many women fear. The evidence shows it is safe for the vast majority of women, even those who cannot take systemic HRT.”
The British Menopause Society confirms this, stating that vaginal oestrogen can be used long-term and is highly effective at relieving vaginal and urinary symptoms (BMS guidance).
Unlike lubricants or moisturisers, which can give temporary relief, vaginal oestrogen treats the root cause by restoring the health of the vaginal tissues. Many women notice improvement within weeks, with full benefits after a few months.
The Impact on Everyday Life
The benefits of vaginal oestrogen go beyond physical comfort. Women often describe it as transformational for their confidence, relationships, and sense of self.
Dr Poet shared,
“I have patients who come back after starting vaginal oestrogen and say, ‘I feel like myself again.’ They are sleeping better, they are no longer dreading intimacy, and they are not running to the toilet every hour. It changes lives.”
These improvements ripple into every part of life. Comfortable skin means better sleep. Enjoying intimacy again strengthens relationships. Not worrying about bladder urgency restores confidence at work and socially.
When to Seek Help
If you are experiencing vaginal dryness, pain, irritation or recurrent urinary infections, it is worth discussing vaginal oestrogen with your GP or a menopause specialist.
Dr Poet encouraged women to advocate for themselves,
“Do not wait until symptoms are severe. The earlier you treat, the quicker the recovery. And if your GP is not sure, ask them to check the guidance. You are entitled to this treatment.”
You can also find support and information from trusted UK organisations such as:
Frequently Asked Questions
Is vaginal oestrogen safe if I have had breast cancer?
For many women, yes. Because the dose is so low and acts locally, it is often considered safe even after breast cancer. Always discuss with your oncologist or menopause specialist.
Do I need to stop vaginal oestrogen after a few months?
No. Unlike systemic HRT, vaginal oestrogen can be used long-term. In fact, stopping usually leads to symptoms returning.
Does it have side effects?
Most women tolerate vaginal oestrogen very well. Occasionally there may be local irritation at first, but this usually settles.
Is it available on the NHS?
Yes. Vaginal oestrogen is available on NHS prescription. If you struggle to access it, ask to be referred to a GP with a menopause interest.
Empowering Women to Choose
The central message from Dr Poet is empowerment.
“You do not need to suffer in silence. Vaginal oestrogen is safe, effective and widely available. Choosing it is not vanity, it is self-care. It is about quality of life.”
Menopause is a stage of life, not the end of it. With the right support, women can continue to thrive, enjoy relationships, and feel confident in their bodies.
Normalising conversations
Vaginal oestrogen is one of the most effective and underused treatments in menopause care. It addresses symptoms that can feel deeply personal and isolating, yet it does so safely and simply.
As Dr Poet reminds us,
“We need to normalise these conversations. Vaginal health is part of women’s health, and it deserves the same attention as any other aspect of wellbeing.”
For women considering treatment, the first step is to start the conversation. Whether with your GP, a menopause specialist, or through trusted resources, know that help is available and you do not have to struggle alone.
And just as looking after your intimate health is an act of self-care, so too is treating your skin with kindness in other areas of menopause. If you use HRT patches, you’ll know that sticky residue can cause irritation. Nudi Spray® was created to help, a gentle adhesive remover designed by women, tested on ourselves, and made to keep your skin comfortable.
Because confidence starts with comfort, in every part of your body.
