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    Topical Estradiol dosage and application
    blissless24 posted:
    I have been menopausal for over a year and still have my uterus and ovaries. My doctor prescribed topical Estradiol with Vit. E 2 mg to be applied to the vulvar vestibule twice daily to treat vaginal atrophy. The instructions say a "small amount" and do not specify exact amount or duration. Also, no instructions as to how to apply, with finger, with syringe, etc. Last, I thought that for women with an uterus, Progestin should be used together with Estradiol. Please advise.
    Mary Jane Minkin, MD responded:
    Dear Blissless24,
    One of the problems of getting compounded medications is that it is difficult to find out exactly how much active medication you are getting. If you were getting the standard Estradiol vaginal cream (estrace cream) you would be receiving with the tube a standard applicator; and you would use 1 gram of the cream (basically one quarter of the applicator); eventually once the atrophy was under control, you would be using it about twice a week. you can use that applicator to insert the cream into the vagina; if you are having external dryness, you would take that amount of cream and rub it around your vulva. With topical estrogens (local estrogen therapy, or LET), you do not have to use progestin therapy because of the small amount of estrogen absorption. So I would go to the website for Estrace cream, which is the closest pharmaceutical product to what you are getting, to get more information.
    Good luck,
    Mary Jane

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