Topical vaginal oestrogen creams can reduce local symptoms, but the systemic absorption is variable and it is not known how much oestrogen is absorbed systemically following use of topical oestrogen preparations.
Estring is a vaginal ring worn continuously for three months which provides local effects and is said to result in less systemic absorption. VagifemŽ is a pessary containing a small amount of oestrogen. It is used daily for two weeks and then reduced to twice a week. It contains such a small amount of oestrogen that it is unlikely to affect the rest of the body. Ovestin (Ortho-gynest) is a cream or pessary that also contains such a small amount of oestrogen that it does not cause any hormonal influences elsewhere in the body. It can reduce dryness and itching for a short time.
Replens is a non-hormonal cream that can be used two or three times per week. It binds to the vaginal wall and rehydrates cells and boosts blood flow to the vagina. Non-hormonal water-soluble products such as Senselle may provide some relief. An alternative for women not helped by Replens is SYLK, a water-soluble lubricant derived from kiwi fruit vine extract.