Low-dose vaginal estrogen therapy is frequently used to prevent recurrent urinary tract infections and/or to treat of symptoms of vaginal atrophy. Vaginal atrophy is thinning and loss of elasticity of the vaginal lining, common after menopause. Symptoms of postmenopausal vaginal atrophy include abnormal vaginal discharge, itching, or irritation. Many women also develop pain with intercourse. Vaginal estrogen is the most effective and evidence-based form of UTI prevention among perimenopausal and postmenopausal women. Vaginal estrogen may also be used in premenopausal women with low-estrogen for similar symptoms. Premenopausal woman can be hypoestrogenic from common conditions such as breast-feeding or prolonged use of contraception that has suppressed ovulation and therefore has also suppressed native ovarian estrogen production. Vaginal estrogen is absorbed topically by the cells in the lining of the vagina, with very minimal/trace absorption into the blood-stream. Therefore, use of low-dose vaginal estrogen is generally safe for women previously treated for hormone-receptor positive cancers such as breast and endometrial cancers.
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