Ask the doctor: Does vaginal estrogen have the same risks as oral or patch estrogen?
Low-dose vaginal estrogen (creams, tablets, and a vaginal ring called Estring) acts predominantly locally, mostly in the vagina. It relieves vaginal dryness, burning, and pain with sexual intercourse, but not hot flashes. Vaginal estrogen doesn't raise blood levels of estrogen enough to stimulate the overgrowth of endometrial cells, so it's thought that progesterone isn't needed. So far, no well-designed clinical trials have evaluated systemic risks, such as breast cancer or blood clots, in women using low-dose vaginal estrogen. But it's unlikely that the risks are similar to those of systemic estrogen.
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