Low-dose topical vaginal estrogen for vulvovaginal itching
Low-dose vaginal estrogen (estradiol 0.01% cream) is indicated for menopausal vulvovaginal atrophy symptoms, which can present as vulvovaginal itching. [1]
Dosing and administration
Low-dose estradiol vaginal cream is administered as intravaginal therapy using the calibrated applicator. [1]
Usual dosing for menopausal vulvar/vaginal atrophy is:
- 2 to 4 g daily for 1 to 2 weeks. [1]
- Then gradual reduction to one half of the initial dose for a similar period. [1]
- Maintenance dosing of 1 g, one to three times per week after restoration of vaginal mucosa is achieved. [1]
Application instructions emphasize correct use of the provided applicator and calibrated dosing. [1]
Contraindications
Estradiol vaginal cream should not be used in the presence of any of the following:
- Undiagnosed abnormal genital bleeding. [1]
- Known, suspected, or history of breast cancer. [1]
- Known or suspected estrogen-dependent neoplasia. [1]
- Active deep vein thrombosis (DVT) or pulmonary embolism (PE) or history of these conditions. [1]
- Active arterial thromboembolic disease (examples include stroke or myocardial infarction) or history of these conditions. [1]
- Known anaphylactic reaction or angioedema to estradiol vaginal cream, 0.01%. [1]
- Known liver dysfunction or disease. [1]
- Known protein C, protein S, or antithrombin deficiency, or other known thrombophilic disorders. [1]
- Known or suspected pregnancy. [1]
Systemic absorption may occur with use of this local estrogen preparation. [1]