The decline in hormones and resulting hormonal imbalance in a woman’s body during menopause can cause uncomfortable and painful symptoms. One of the most painful symptoms of declining estrogen production is vulvar and vaginal atrophy. Declining levels of estrogen can lead to vaginal dryness, itching, and burning. Inflammation and lack of lubrication can make sex painful and everyday life uncomfortable. With hormone replacement therapy these painful symptoms of hormone decline can be reduced. Estradiol (E2) is one of three estrogens produced in a woman’s body and is one of the most frequently prescribed estrogens for hormone replacement therapy.

Relief of Menopausal Symptoms with Estradiol

Estradiol applied directly to the vagina is indicated for the treatment of moderate to severe symptoms of vulvar and vaginal atrophy due to menopause. Vaginally applied estradiol works to improve levels of estrogen to repair vaginal cells over time. The normal discharge of fluids that lubricate the vagina can be reduced when stimulation by estrogen declines during menopause. Using lubricants can provide temporary relief but hormone replacement treats the cause of pain and discomfort. Vaginal health can be restored and quality of life improved with estrogen replacement.

Delivery of Estradiol

Since estradiol is metabolized heavily when taken orally, vaginal administration is the preferred method of delivery. Vaginal administration avoids the metabolic breakdown of estrogen that results in a low bioavailability of the hormone. When used at low doses it also reduces the chance of side effects that can come from estrogen taken orally. Low dose vaginal estrogen therapy can be continued indefinitely.

Estradiol taken orally will almost always be prescribed along with progesterone to prevent estrogen dominance, which can cause health complications. With low doses applied vaginally however this is not always necessary. Achieving an optimal balance of hormones is essential to most effectively reduce menopausal symptoms. This balance can be achieved with hormone replacement therapy using a combination of hormones.