Should I prescribe local oestrogen for postmenopausal women with vaginal atrophy?
Conjugated equine oestrogen cream is more likely than oestradiol tablets to cause uterine bleeding, breast pain and perineal pain (NNH*10). Compared to the oestradiol ring this cream is also more likely to cause endometrial overstimulation (NNH 14). * NNH = number needed to treat to cause harm in one individual
Vaginal atrophy is a common condition in postmenopausal women, causing vaginal dryness, itching, discomfort and dyspareunia. Systemic treatment in the form of oral hormone replacement therapy is not always necessary – several local oestrogen preparations are available.