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Absorption of vaginally applied Estrogen

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I am a 27 year old female.

Is vaginally applied Estrace (estradiol vaginal cream) supposed to be absorbed completely, and if so, how long does it generally take? I was recently prescribed 1g Estrace cream to be applied vaginally every 3 days, however, it seems that the majority remains in the vaginal canal and does not absorb completely or just works its way back out over the next 2 ~ 3 days.

I was prescribed the estrace cream approximately 13 months post vaginoplasty due to recurrent bleeding during penetrative intercourse. The vaginal canal upon examination, prior to being prescribed the cream, was observed to be fully healed with no signs of open lesion or otherwise, and thus my gynecologist felt that the use of the medication would assist in creating more elasticity of the vaginal wall, which they felt was liking tearing during penetrative intercourse.

My vaginal canal produces very minimal amounts of secretion / moisture and I always require lubrication during any form of vaginal insertion. The vaginoplasty was primarily created out of skin graft material, and thus is not like that of a "normal" vagina. I have no ovaries, uterus or cervix present and rely solely on medication based hormones.

Category: OBGYN

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Category: Infertility Specialist
Dr. Aarti Vazirani is online now

Expert:  Dr. Aarti Vazirani replied 4 Days.


Thanks for your query at DoctorSpring.com.

The cream is completely absorbed into the circulation, and its effect stays for 48 - 72 hours, which is why it is prescribed over 2 - 3 days period.
The neo vagina that is fashioned after vaginoplasty does not resemble a 'normal' vagina in terms of shape and rugosity etc, hence it might not retain the cream that well, but rest assured, the hormone content gets absorbed within a few hours into the bloodstream.

The hormone is worked into a cream / gel base , and the hormone gets absorbed int he bloodstream, and what stays behind is the cream / gel, hence you get the feeling that it gets left behind.

Also, using vaginal estrogen increases your production of local secretions, hence the wetness might be confusing you too.

It cannot work its way back once it has been absorbed, do not worry about that.
Continue using it , as it would help in healing and epithelialization of the neo - vagina.

All the best.
Please feel free to ask for further clarifications.


Dr. Aarti Vazirani
Category: Infertility Specialist
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
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