How safe is vaginal estrogen for ongoing use?

Vaginal estrogen is considered extremely safe for ongoing use. Here at Alloy, our menopause-trained doctors and medical advisors emphasize that vaginal estrogen (like our Estradiol Vaginal Cream) is a very low-dose, localized treatment. It is absorbed mainly in the vaginal tissues, with minimal absorption into the bloodstream. This means it does not carry the same risks as systemic hormone therapy, such as increased risk of blood clots or breast cancer.

Vaginal estrogen can be safely used by most women, including those who are older, those on systemic hormone therapy, and even many breast cancer survivors (though always discuss with your oncologist if you have a history of breast cancer).
There is no evidence of increased mortality, blood clot risk, or major harm with ongoing use.
It is FDA-approved for long-term relief of symptoms like vaginal dryness, itching, burning, painful sex, and frequent UTIs.
Most women see significant improvement in symptoms within 4-12 weeks.

For more details, you can:

Read about our Estradiol Vaginal Cream
Watch the YouTube chapter on the Safety and Risks of Vaginal Estrogen for expert reassurance from Dr. Rachel Rubin
See the Medical Consensus on Vaginal Estrogen Safety with Dr. Mary Jane Minkin

If you’re interested in starting treatment or want to learn more, check out our product page for Estradiol Vaginal Cream or take our quick online assessment to get personalized recommendations from an Alloy menopause specialist.

This answer was created using the following resources: