VAGINAL ESTROGEN: HOW AND WHY TO USE THEM TO KEEP THINGS NORMAL DOWN THERE!

[@larajohnson8174]

This is an excellent video about estrogen specifically for the vagina. Despite reading so many menopause books and also watching Menopause Barbie, I love learning from you as well! Thank you for taking the time to do this! So valuable!

[@heatherhirschMD]

Thank you Lara so much for that!! Really made my day and glad they are informative and fun to watch!

[@larajohnson8174]

@@heatherhirschMD Perfect timing too Dr Hirsch! I’m seeing my menopause specialist (OB/Gyne) this morning and will ask her about vaginal estrogen. I love that you’re teaching us to be proactive with our health. Hugs to you!!

[@leawhite8432]

Thanks sooo much for all that you do. I was really struggling in this process of perimen/menapause and didn't have anyone to talk to, and recently started searching info on this topic and speaking w/my doctor. Your outstanding as I continue on life journey, your a blessing😊. Thanks

[@parvinmohammadian9977]

Hello dr. Heather I need to ask you a few questions ? You may answer me or just this message will be lost Dr. I had hysterectomy that a doctor ( to me he didn’t have enough education and did that to me that didn’t have any problems just fibroids .) so I was in my late forties had a complete hysterectomy and didn’t have a hormone replacement and not having sex for many years almost 25 years now I am 70 years old and I feel like so many things have changed down there I like to have sex but I cannot it is so dry and inter course is so painful and no libido of course just couple of days age I went to doctor and she gave me estradiol vaginal cream . I need your help , will my level of desire ever get back to what it once was? What treatment are available?

[@salmanmcfraggle401]

High pH means Less acid. Please correct this misinformation

[@paulinesmith6553]

Why are these vaginal estrogen medicine over $200 and viagra is under $20. Drug companies need to get some priorities straight. If mama ain’t happy, you know the rest.

[@heatherhirschMD]

I love this and yes we all agree!

[@Wendy63Lorraine]

Omg, that’s obscene. It’s only $20AU dollars in Australia. I literally could sell it to you from here, with postage.

[@caryinky]

Really? I just bought my first estrogen cream today from a compound pharmacy which insurance won’t cover. It cost me $45. I guess that’s way better..? But still not happy insurance won’t pay for it. That doesn’t seem fair at all. But I’m thankful it’s not more than what I had to pay.

[@paulinesmith6553]

@@caryinky It was $200 when this video first appeared.

[@bluejean-1968]

You can literally buy estrogen and estriol cream (high quality with minimal ingredients) over the counter. Ona's Naturals is great stuff. Just use that. No need for a prescription.

[@bethfuller4221]

I have dealt with all of these issues for more than 2 years, until I was finally referred to a Urogynecologist who prescribed vaginsl estrogen. I don’t understand why my regular Gyn didn’t prescribe this snd let me suffer for 2 YEARS!!!! Thank you for spreading this word!

[@Ayyeliki]

My gyn is a member of NAMS and is highly interested in the menopause, but he claims most ob/gyns dont go into the field for the menopause part of it- the OB part usually attracts- think about it…makes sense, so sadly, lack of knowledge abounds! 🤷🏼‍♀️

[@Tricia2023]

Omg me too 😳 Like why would my gyno not tell me about this for the last 8 years !

[@suepete]

My gyn retired 3 yrs. ago. He was a genius. Gave me estradiol cream which was miraculous. Fast forward 5 or 6 years.... I get same problem, go to another doc in his practice and the guy can't figure it out and orders compounded meds that didn't help at ALL. He couldn't think of the word ESTROGEN? Unreal! My GENERAL PRACTITIONER thought of estrogen in 5 seconds and is ordering it this morning! Go figure! 😮

[@Skinnychelle48]

Have so many questions. My gyno just prescribed estradiol vaginal tablets for pain, 8 of them. I’m wondering why just 8?

[@judithdolan-wood3642]

Took Premarin 2wks thru the barrel.ob tells me caused endometriosis? I'm 60 how? Then was given estrodial in a week I felt like I was on fire.ant suggestions.obgyn is no help at all

[@KatieJoMikell]

I am almost 2 decades past Surgical menopause and I’ve been having more symptoms lately. I had prolapse surgery about two months ago so I ended up at a gynecologist that I searched for that specialized in menopause and she’s putting me on estrogen cream to try and a little testosterone, but never in my lifetime has any gynecologist ever ever ever discussed this with me and my body and what I could do to help it shame on the community for giving up on women’s bodies post menopausal Shame on you doctors! Not you Dr. Heather you’re amazing, I wish you were in Chicago. I would be signing up to be your patient tomorrow!

[@lornajamroziak9307]

Thank you I’m 64 and have had such terrible pain it was even hard to walk, found a woman dr. Today and have started the cream I have hope now.

[@allywolf9182]

I kid you not... I'm literally crippled now because of no estrogen. The pain is unbelievable.. like a 7-8 all the time. My tendons are actually dissolving. I have Achilles tendon issues, knee issues, and now gluteal tendonapathy which is excruciating.

[@user-dn9vd9xg9p]

Thank you for this! It is good to hear a female that understands females. How many females have been to a Mississippi urologists and were brushed off by these docs and found out later they had kidney stones, a terrible infection, or blood in their urine or something simple like needing estrogen as this female doc suggested? How many found out they had post menopausal symptoms, or parathyroid issues causing kidney problems causing kidney stones from high calcium counts? Females have no recourse here so it is so good to find this out from a female doctor. Thank you! Thank you! It is refreshing to hear intelligence and from a doctor that cares!

[@piki4862]

I've had painful intercourse for a year. I just turned 47. Hormones are "normal". I've had ultrasounds, interuterine biopsy and a pap. Satisfied that I don't have cancer, my gynecologist finally prescribed vaginal estrogen. 🙌🏼 I had no idea this can get worse 🤯

[@natashacoon9776]

I am 40 and am pre menopausal..extremely early!! I have painful intercourse. Particularly at the opening...well you shoukd know what I mean lol. I just got prescribed this cream. Have you noticed a difference using this cream as far as you know what being painful?

[@JanColby-jt6ut]

@@natashacoon9776

[@CalmVibesVee]

Did it help? I need a miracle

[@MrsSheffield]

I wish gynecology oncologists were trained in this...I know their focus is on the gynecological cancer, but the side effect following treatments is immediate menopause and they kind of leave you hanging. I had to navigate the symptoms and try to figure out what the heck I was going through after the cancer treatments were over.

[@Cerceify4645]

I had breast cancer, just ductal insitu so no other treatment except the mastectomy and Tamoxifen. 10 or more hot flashes a day x five years. Now I'm on raloxifene, another yew derivative, for oxypirosis and the breast cancer. My gynecologist allowed me to stay on Estring as long as I keep taking the raloxifene.

[@sylviaking8866]

Menopause sucks. From the age of 40 we do not get optimal care to help deal with the decline.

[@martinaconroy2328]

Not just menopause also perimenopause

[@jessicahitchens6926]

All of it is related to hormonal dysfunction and deficiencies. Every girl/woman needs to be informed on this and can use it at any age after menses etc.

[@evaaiken9057]

I’m going to mention this to my perimenopausal daughter. I just am starting this cream today. Sure wish I’d known sooner. I was misled by my doctors and nurses and have finally found an OBGYN who knows what she’s doing. I’m praying for relief soon!!!

[@JenXGirl]

My dr refused to give me estrace So I’m switching drs. I’m very upset. I found a dr. on your link and made an appointment.

[@heatherhirschMD]

Wonderful! as you should - glad that helped!

[@ivalani]

So I have watched most of the menopause education channels and I consider this one the best and most informative-thank you!

[@upperleft3607]

Oh. My. GOSH!!! My jaw dropped when you brought up painful urination that WASN'T an infection! I am a 37-year-old Triple Negative breast cancer survivor and am on Tamoxifen to suppress estrogen because my tumor had SMALL markers of estrogen. I've been on Tamoxifen for about 8 months now. 3-4 months in, I noticed UTI-like painful, frequent urination. I saw my doctor and had a urine culture which came back 'normal'... but how could it be normal?? I was in pain all day, every day... I began to think the chemo/medication potentially gave me some type of bladder cancer (every pain makes me think I have cancer again.. ack!). To top it off, my fiance and I haven't been able to have sex for almost a year because Tamoxifen has put me into early menopause and I have vaginal atrophy. My partner is very girthy, so sex is impossible right now which makes me feel 'broken' and I'm sure he's frustrated, as well. I began taking D3 supplements once a day a few weeks ago and my bladder pain has disappeared, thank goodness, BUT I had no idea it could be related to low estrogen from medicated menopause! That makes SO much sense. I've reached out to my OB-Gyn to talk about potentially prescribing vaginal estrogen to counteract the atrophy from Tamoxifen. Fingers crossed!! Thanks for sharing your knowledge with the world :)

[@upperleft3607]

OB approved my request for estrogen and I started last week! Can't wait to get back to 'normal' in the bedroom LOL

[@shadowprovesunshine]

Same here but lymphoma survivor w/fam x of bc. They just rx'd me youvifem, but I dont think I want the generic after all I've been through. Also I take AVO if I start having urinary pain (I already take 5000 to 10,000 D3).

[@tlc6756]

I know this was a year ago, but I'm 12 years postmenopausal and natural progesterone ( not Progestin, the synthetic kind) really helps to lubricate me naturally just by taking progesterone drops orally or rubbing the cream into my wrists/feet (you don't need to put into vagina). It seems to help make my vaginal tissues inside more "cushioned", so I'm wondering if it heals similar to estrogen/estradiol. Hope this helps 😊.

[@CalmVibesVee]

How much D3 do you take to make urinary pain better? I just started the cream. I pray God blesses this . I need a miracle. Help us Lord.

[@delaneyondreams]

It is a delight to hear your dog bark while you work! His woof was not intrusive at all to me, but a reminder that you have created a life in which you sac enjoy the love-generating powers of a dog!

[@karenmcgroarty4187]

I am a breast cancer survivor, I have been given ovestan (estradiol) x2 weekly Haola femme moisturizing gel x2 daily I'm in Scotland

[@letitiamcculley9311]

How long did it all take to work so you had relief????

[@karenmcgroarty4187]

@ almost instantly. I had the hyalofemme gel for a while. I was bleeding due to the tissue being so dry and chaffing. I spoke with GP who spoke with breast nurse. She said it was safe for me to have the ovestin cream which is Estriol. GP said estriol will plump up the tissue. I use it twice a week.

[@sayuriisme9728]

Thank goodness for this video! I just started on vaginal estrogen and was looking at the literature that came with it. It’s a little scary😮.

[@Sirie7206]

So glad I found you. Just left my doctors because I’m experiencing these symptoms. I can’t decipher whether it’s my bladder or vagina. I’ve been tested for UTIs, STDs, BV and yeast and all come back negative. I’ve been given antibiotics and I’m still in discomfort. It feels like irritation and urinary urgency that comes and goes. So he prescribed me vegifem to rule out atrophy. I’m so glad you confirmed the safety of these medications that he had mentioned too. I hope this helps me. I’ve been dealing with this discomfort for 3 months.

[@LoveABun]

Are you feeling better now? Which form of vaginal estrogen did he prescribe for you? I’ve been on vaginal estrogen for 3 yrs yet still am like you. I feel like I have a perpetual UTI, but tests and swabs always come back normal.

[@maplenook]

Drink 3 liters of water

[@Sirie7206]

@@maplenook I did and it made the pain worse.

[@Sirie7206]

@@LoveABun Yes, I am. I didn’t end up using the vegifem. My Functional Pharmacist prescribed me Estriol 0.1% vaginal cream. It has stopped the UTI like symptoms. I also stopped drinking coffee. I feel like coffee made things worse. Whenever I feel that UTI sensation I apply a little bit of that cream around and in my labia, and it’s been working great. I also take probiotics. These changes have stopped whatever was going on.

[@user-zd1rb6hn7d]

I have been so Afraid to try creams due to having a brain tumor removed in 2017 . I wasn't sure if using vaginal estrogen cream would get in my system. I'm sitting here with happy tears Because your kind helpful informative video has helped me understand and feel safe to move forward with using an estrogen cream. If I could hug you I would! Please know that you are greatly appreciated! Thank you from my heart of hearts for helping us all understand menopause!

[@heatherhirschMD]

You are very welcome! There is absolutely NO reason you could not use vaginal estrogen (even systemic estrogen for that same reason) This is NOT a contraindication

[@anniematthew2608]

The doc did say that v cream is not systematic, however a person wrote in the comments that she was using the cream in the v spot yet had systematic side effects. Proceed with caution.

[@shirleycottle2047]

I started getting migraines with the cream ?

[@deannajohnson7816]

Thank you for your video series! I’ve been binge watching your videos before I see my doctor next week. Your presentation is very clear and upbeat-not dry or negative. It is SO important for us patients to be armed with all this information when we visit our doctors.

[@heatherhirschMD]

Thank you Deanna! That means so much to know! Appreciate the comment and kind words.

[@emilyh4127]

Please do a video why you don't need to add progesterone when taking vaginal estrogen. Many studies say that you have to add progesterone to vaginal estrogen if you still have a uterus, otherwise it could increase chances of uterine cancer. Please do this video! Thank You!

[@tlc6756]

I'm not an expert or Dr., But I agree that natural progesterone should be taken along with any estrogen type product. In fact some Drs. recommend taking natural progesterone alone to keep the lining of the uterus thinner to prevent cancer. I actually have found that either natural micronized progesterone (taken orally) or natural progesterone cream (that's rubbed into skin/wrists/feet) lubricates me wonderfully, increases libido and mood/relaxation.. My inside vaginal tissues feel healthier too. I call it my liquid gold😃. Remember that Progestin is synthetic and is the type that can cause blood clots/strokes etc. It's possible natural progesterone may cause those but I think only if you take too much. I've taken the natural off and on since menopause and it's like I practically didn't even have a menopause (a few warm flashes, but no hot flashes/decreased libido/decreased lubrication. I've also tried (a few times) some natural estriol or estradiol creams rubbed into skin ( inside vagina, but mostly into wrists) and I know it went systemic because I pretty quickly had extra energy/motivation). It may not be enough to cause cancer, but my experience was that i felt it went into my bloosstream.

[@LoveABun]

This is NOT TRUE! Trust me on this. I follow numerous gynecology and female urology and sexual medicine experts and my doctor is one, as well. Vaginal estrogens are extremely low dose and work solely on local tissues. They are effective by themselves. Progesterone is NOT required nor is it safe to use alongside vaginal estrogen. Doing so can lead to uterine cancer for some women!

[@patriciapyper4617]

What about side effects please thank you ♥️

[@katekepenis3697]

Thank you so much for including the breast cancer survivors! Not enough menopause Drs address this community and only address systemic HRT which is not an option for us. We have all the side of menopause with the added side effects of estrogen blocker medications. Learning about vaginal estrogen options gives us hope!

[@aylen3322]

Yes please please include more videos for BC survivors. I am scouring the internet for information and even reached out to BC survivors. Getting this info is a full time job.

[@velroneramdon2289]

I am still scared it might cause cancer

[@rmslovesmjs]

thank you so much! You are a God send. I have no friends my age (40) going through any of this (surgical menopause) so glad to have found you. you are a breath of fresh air! thank you!

[@janetwilson4339]

Thank you for the information. I just had a total hysterectomy due to ovarian cancer. I’ve been having bad hot flashes & asked my oncologist for HRT & she told me absolutely not that HRT is actually like fertilizer for cancer. She told me I would just have to deal with the hot flashes

[@theresawebb8064]

I had a total hysterectomy at age 32 because I had benign tumors but my mom had died at age 49 from ovarian cancer .I couldn't have kids because my tubes were tied already, my Dr was hesitant about a hysterectomy..but my mom had also had benign tumor taken out yrs before she died... But she only had the tumor removed probably when she was was about age 30.. then at age 47 she started hurting went to Dr and because she still had the ovaries she had stage 4 ovarian..she died at age 49..so when I saw those solid benign i wasn't taking chances .I told him if he wouldn't do it..id find another Dr ..so almost 27 yrs now ..I had hysterectomy..cold turkey no estrogen.. BECAUSE my mom may have had the breast ovarian gene .and they wanted to give me a pill..I said NO. I didn't want breast cancer..I do have solid lumps in both breast ..but there fibrous and benign..they found them bout 8 yrs ago .I go get mamo every yr or so to check for changes ..I finally had to listen to a Dr that assured me the vag estrogen was SAFE when I Started having pain and bleeding..but I'd went 20 yrs without anything..grit your teeth and bare it thing u know..I've realized the more I take it as Dr recommended it seems the bleeding has stopped .I've not been sexual in near 2 yrs..I was having like a brown like dark blood..just a tad till i weara pad daily to safe my underwear .but I was scared and not taking the vag cream as recommended..but have realized if I use it once or twice a week it seems to help..as far as a lub ..even before estrogen is use coconut oil or olive oil..THATS JUST ME IM NOT A DR AND NOT ADVISING THAT FOR NOBODY it just seemed the oils for lube helped me..cause store bought kind burned. Even now I'm not sexual I still use the oil occasionally vaginally to ease and makes things feel better for ME. But do WHATEVER ur Dr says

[@crepesuzette5540]

Thank you for always remembering your followers who had HR+ Breast Cancer with successful treatment! When will there be systemic HRT for us? Many of us are going rogue and doing HRT because of Quality of Life issues without HRT and because the science does not seem to be settled on the weather HRT is protective or a hazard for breast cancer survivors.

[@shadowprovesunshine]

Yes! I had lymphoma and med mp and because of fam history they won't do systemic. I'm only 43 and not ready to have this part of my life ended.

[@sharonbartley808]

I am 63 and still have sex drive. Went into menopause at 59. My urogyn put me on estradiol vaginal cream because of my frequent and urgent urination. But I don't have those other issues like dryness or no sex drive etc.

[@kamap.4525]

Lucky you! I suffer terrible pain and dryness, can't hace sex :(

[@flamboyant731]

I'm having the same issue. Did it work for you?

[@tallulahtwosocks6214]

I just changed dr.s due to lack of education on this subject where I live. I now drive 3 hours to get to my new doctor in MIA who is a god-send! She is on the same level of education and experience as you! Thank You for your channel!!! And one of my sexy nights is Thur. 😂

[@heatherhirschMD]

YES! Awesome! Sorry you have to drive, but probably worth the miles :)

[@deborahg427]

Can you share the name of your doctor in Miami?

[@leticiatorres7485]

My Dr prescribed both the estradiol patch and the vaginal cream. The first pharmacy didn't want to give me both because they said it was the same thing and the second gave them both to me but not until the pharmacist warned me not to use them both on the same day. Do pharmacists not know that the vaginal estradiol is not systemic? Obviously my gynecologist prescribed them both and knows better than the pharmacist 🙄

[@rhondajones8678]

I have severe GSM with multiple UTIs yearly. The estradiol caused severe yeast infections, itching burning! What other options do I have? I definitely don’t want oral estrogen or patches due to fear of cancer.

[@OhhKikka]

Try Imvexxy

[@maplenook]

Drinking 3L of water can help urethra irritation Also coconut oil applied externally

[@mushymystic]

Estrone, Estradiol, Estrione? These are important to distinguish, they are three different oestrogens which are present throughout different life-stages, Estrone never disappears... You need to be specific about E1, E2, E3 levels which you want to monitor (:

[@analiabertoni9793]

Estriol?

[@mushymystic]

@@analiabertoni9793 yeah lol what was i thinking. I was having “a day”

[@Delanahw]

Thank you for explaining the difference between the estrogens, animal based vs. plant based. I do not want to use a product that tortures animals. It is unconscionable what they do to female horses and the little babies they are forced to have over and over again to produce estrogen for human use.

[@MrsSheffield]

The family doctors, and most gynos even, are NOT knowledgeable at all regarding any of this, SO most women are stuck dealing with these doctors, arguing with them, trying to teach them about it, fighting for HRT, etc. IT's sad that they are not MANDATED to do some sort of continuuing education in terms of dealing with menopause/HRT.

[@lori7008]

Its tough being a woman for sure! Thanks for great info! This is reasurring. Love your happy personality. Wish you was my Dr. For sure!

[@cobb5351]

I discontinued using Estrace due to its messiness, but since then, I haven't felt the same. I'm considering asking my doctor to prescribe it for me again.

[@sonyalake989]

Thank I feel more relaxed I was not sure about the black box that says could cause cancer you cleared that up for me.

[@christineb1891]

Thank you so much for this excellent information. You are the first person on KZbin that can explain it very well.

[@heatherhirschMD]

Thank you Christine! Much appreciated!

[@nancykennedy9397]

I have had overactive bladder for years and tried medications for that which were horrible. Hoping maybe this will help. Going to ask my doctor.

[@zenfan1098]

What about the bad ingredients in it parabens etc...

[@banderson6102]

I have to insert it in the morning because if I use it at night it gives me insomnia - which I read is a side effect for some. It stays up there even with me inserting it in the mid morning. No panty liner needed and its working.

[@joyjoy-u6t]

What are the symptoms you were having that this is helping?

[@PhildaNcindi]

Soo informative .Ive been suffering from urinal infections from my 30 's vaginal dryness that caused soo much tension with my hubby. Litle did I know the cause .Now I am 66 years suffering from prolaps uterine or bladder not sure premarine was prescribed. I felt warmth underneath no more dryness or itching. Thank you for info

[@d.h.1827]

My experience with estrace cream was horrible. It fixed the dryness issue but gave me very bad side effects. Splitting headaches, terrible breast pain and severe heart palpitations. So that says to me that the estrogen doesn't just stay in the vagina. Then I tried bioidentical estrogen vaginal cream and dealt with trigeminal neuralgia as a side effect, which fortunately went away when I stopped using it. I've tried over the counter replens and that was not a long term solution either. I would gladly use estrace 2x a week if it didn't have such terrible side effects. Nothing I have tried works with out terrible side effects or as a long term solution. I also wonder about the studies that say estrogen stays in the vagina, bc that was not my experience. I recently started using bioidentical vaginal cream with both progesterone and estrogen. So far no side effects but relief is slow so far. This has been a very frustrating problem to solve and so far the solutions have not been viable for long term use. And there does not seem to be real life info out there for a long term solution.

[@heatherhirschMD]

So sorry to hear you had that experience. This also shows that all women are not the same, and that you were very sensitive to this. Imvexxy is estradiol that comes in 4 MCG - the lowest dose on the market (all others are 10 mcg) so you might want to try that, or consider prasterone (Interosa) which is DHEA, more "inactive" then estrogen products. Or, use just once weekly.

[@d.h.1827]

@@heatherhirschMD Thank you! This has been such a challenging problem to solve these past few years. I also know I'm not alone bc there are so many reviews on various sites by women who are looking for relief and having difficulty finding it.

[@ms.c76]

I am so scared about headaches! I suffer of migraines and l am scared to use the cream. My doctor told to try… did your headaches disappear right away when you stopped the use of the cream?

[@d.h.1827]

@@ms.c76 The headaches and all side effects went away when I stopped using the estrace cream. I started using OstaDerm-V cream by Bezweken afterwards and it works well with no side effects.

[@shirleycottle2047]

@@d.h.1827where did u get the other cream

[@larajohnson8174]

Sorry for another post, Dr Hirsch, but I wanted you to let know how helpful this video has been. I am on several menopause forums on Facebook, and there are so many women suffering with chronic UTIs and bladder leakage, and I have posted your video in the chat, to let them know about vaginal estrogen!

[@casapilanola]

my dear Mama got endometrial cancer from vaginal estrogen. 6.5 years she fought that horror and finally passed in hospice. I am terrified of that. Meanwhile, my atrophy is awful. My libido and sex life is just about over; my boyfriend thinks i am CHOOSING to not sex right now. He does not understand ... I wish there were SAFE options that would not bring cancer.

[@LoveABun]

Vaginal DHEA in the form of the prescription suppository called Intrarosa has been shown in multiple studies to be as effective as vaginal estrogen. It is an excellent, safe alternative for women who cannot tolerate vaginal estrogens. My gyno is a hormonal specialist and he actually prefers Intrarosa for GSM over vaginal estrogens.

[@patrisiamarto7999]

Very interesting ❤

[@patrisiamarto7999]

I wish they had more for women with libido and dryness issues

[@K-qj5ou]

Question: If vaginal estrogen stays local, why does it give me a headache and nausea? 47 perimenopause and have had explained vaginal burning for the past 4 years. Investigated but now I'm trying this route.

[@Rochelle937]

Doctor: The Estriol Cream/Estrace contains methylparaben. Is that safe to use in the vagina, esp long term?

[@maggiemendoza7636]

I was wondering the same thing!

[@analiabertoni9793]

I use Estriol suppositories with olive oil as a base.

[@j.c2195]

How long does it take for vagifem to work and take the pain/burning away?

[@maryjoobrienmoulding6298]

I had a blood clot 10 years ago I keep having uti’s my Dr. doesn’t want me to use vaginal estrogen but my Uro says it would help with Uti’s which just recently has been awful can you speak on blood clot safety.

[@oldnavyluver83]

Yes, more info!

[@debrayarde863]

Hi thks for ur time well spent educating the public about estrogen ...I have never took it so serious untill now listening to ur programm..God bless u in ever espect of ur life.....thks again...

[@lifeslittleluxury3541]

Thank you Dr. Heather for this amazing informative video. My Dr. has me on Imvexxy once per week instead of twice, plus I take oral estrogen and progesterone. The oral (very small doses) was prescribed by my GP. When I wasn't feeling any different in my vaginal area, I sought out a "menopause specialist" in my area and she is the one that introduced me to the Imvexxy. She also said it would be alright to stay on the oral estrogen and progesterone as well.....Is this ok to do? The vaginal estrogen is AMAZING! I am 51 and it makes SO much difference. I cannot believe how many symptoms (I had no idea) that came with menopause. I LOVE vaginal estrogen and hope I can take it forever:) Thank you so much for all your time and information you share with us all. You truly make a difference ❤️

[@assamaahmad4770]

Can I ask which oral estrogen and progesterone you are taking, im pre meno

[@joyjoy-u6t]

What symptoms were you having and what is not occurring now that you are using the vaginal estrogen?

[@constancerobinson1377]

I’m looking forward to going back to my urologist with more questions thank you

[@dianeruckdeschel9773]

You are soooo helpful! Thank you ❤! What a wonderful doctor to take your time to explain all this.

[@nellybeysa7834]

Omg! Had terrible menstrual pain all my life and now I’m starting to have the perimenopause symptoms and it’s gonna get worse and worse! Try to stay positive but it’s not easy 😞

[@winnieholtermann-jensen58]

I am 85 and very activ, BUT I have a lot of problems around vulva it’s extremely painful, however I do have an estring for years, do you think that estradiol cream could help me on with the vulva problems? I have asked other places on youtube but never got a response 😢

[@LoveABun]

YES! Estring will help issues inside your vagina, but is not sufficient to treat external tissues! It’s perfectly common to use both an internal estrogen like Estring or Vagifem tablet and a vaginal estrogen cream on the outside. Get generic vaginal estradiol cream and rub a small amount on the vulva and also the urethra if you are having urinary system problems like burning when urinating or chronic UTIs. Gynecologists who are educated about vaginal estrogens should have no issue prescribing a cream for you to use externally in addition to your Estring.

[@joyjoy-u6t]

​@@LoveABunhow and where do I get generic vaginal cream? Is it prescription only?? Which brand/type do you recommend?

[@evaaiken9057]

Thank you for a thorough explanation.

[@lizherbst7393]

Visuals would be very helpful. Sketches, diagrams….

[@karri8998]

Thank you so very much for this video, I am booking an appointment with my doctor tomorrow to discuss using this.

[@patriciapyper4617]

What cream to use post menopause please thanks 👍♥️

[@LoveABun]

Prescription “generic vaginal estradiol cream”… ask your doctor for this.

[@carlawalker7814]

amazing videos! I was really nervous to try any kind of hrt, even vaginal therapy....but after so many fails with moisturizers I knew that I really needed the help..thank you so much for all of these lovely videos. You are so clear and concise! Love your upbeat attitude!

[@lion69ess]

at around: 5:09. I caught an error, you say as the PH increases the vagina becomes more acidic, but you actually should say "alkaline"

[@michellehattabaugh4743]

Thank you for all of the information! I found you through Angie at Hot and Flashy. I've been doing compounded hormones but after watching several of your videos I'll be finding a specialist. My issue is chronic yeast infections so hopefully I can get some solutions!

[@heatherhirschMD]

I hope so too! I certainly understand that provider training is limited. Check menopause.org and search under find a provider!

[@aewalker3538]

Thank you so much! I am reassured by your video. You are a natural in educating and have a sweet personality.💖

[@dianapaloma3102]

Is the DHEA CREAM safer than Premarin ? Why do women complain about the vaginal crean changing their mood and causing depression if the creams don’t have systemic effect ? Thank you. ❤️🙏

[@pkstiever]

I use systemic HRT and this past year my vagina is starting to have atrophic changes causing pain from thinning tissue. My doctor seems to think my HRT is enough. That's not what is happening, and I've read that it isn't always enough in maybe 20% of the cases of women over 65. Estriol cream seems to do nothing.

[@RosmondMayers]

My worst discomfort is when am sitting

[@sequoiacynthia3843]

Did you say estradiol 0-20? what is the unit please? ( pmol/L or nmol/L ) Thanks for your reply!

[@naomilee2030]

Very informative! Thank you for being positive!!

[@sojoecherry]

Thank you sooooo much for this! What a helpful video. I’ve just started taking Pramerin and the warning scared the crap out of me. My doctor told me to put a dime size on my finger and rub it inside not further than about an inch. 2 weeks straight every day then 2 to 3 times a week. I’ve been scared to use it and put it off for months bc of the warning. The atrophy I have since going through menopause is brutal along with burning and so on. Hoping this works. Thanks again!

[@Ayyeliki]

Your MD instructed you correctly because there are many estrogen receptors just inside the vaginal opening - and that apparently, aid the urethra as well. Don’t be scared - I believe the warnings on the vaginal creams are equivalent to the warnings on the oral tablets and there is a movement to get them changed but, alas,may take a long time. Keep up with Dr. Hirsch and her info, shes spot on with the research and available data and the warnings are, unfortunately, an overreaction to the WHI early findings (The majority of which have been proven faulty after many years). If you read the package insert on Tylenol or Aspirin, you would NEVER take those, either! A dime size amount is considered low dose! Ive been AMAZED at the benefits after about 6 ish weeks of therapy and I’m 60! Just do it! 💪🏻 🎉🎉🎉

[@soy_sweet99]

Yes the warning scared me too!!!! I just got mine and finally used it

[@saimakhan243]

You are using progesterone with it too or with 2 to 3 times a week u don't need progesterone ?

[@lianeisme]

Thank you for this video I have been suffering for so long bleeding from the Urinary track with incredible pain. I actually ended up in hospital for 8 days on IV antibiotics. I have just come out of hospital once again. I had a cystoscopy after the infection left my kidneys also. I was told everything was normal yesterday. Today I’m bleeding from the Urinary track again and suffering pain maybe this may help me.

[@curesometimes]

How r u now?

[@jeanluby4636]

After many trials over 2 yrs. any kind of estrogen causes extreme burning for me Everything's been checked burning continues with or without treatment.

[@widowswatch6610]

Good information thanks

[@barbaraszwedo8697]

Hello Doctor. Do Primarin cream and Vagifem co have the same composition and hormonal concentration (strength)? Can I apply Primarin cream in very small quantities on the wrinkles around my eyes too? Thank you very much. Have a good week.

[@toyinolubiyi3039]

Thanks for sharing. Please can you explain why severe back pain? I’m on my 4th week with the estradiol cream😢 And I’m about to give up!

[@madelineemanuel8801]

Thank you Dr. Hirsch, your information is very educational.

[@lakegirl451]

Dr. Hirsch, what kind of doctor do I look for that specializes like you? I never took HRT and have been in menopause for 13+ years. Just had total hysterectomy and Before surgery, I asked the surgeon if my ovaries were still producing hormones and she said that all the scientific studies stop at 65- I am 66, so , there was no info for me . I now feel like my ovaries did indeed still work somewhat because I now feel more hot flashes, and sadness that I have-never experienced.

[@cmg2651]

My health care provider prescribed Premarin 21 days on 9 days off for the first month, then going to a few days a week after. We’ll see how that goes.

[@lyndabennett1ify]

Premarin imprisons pregnant mares in sheds to collect urine. Their foals are generally slaughtered 😢 please use something else

[@anagabriellat8281]

I can’t believe I haven’t found this video sooner! Thank you so much!

[@teresahernandez8040]

Thank you for the information! It was very helpful!

[@hlmc7571]

I have had utis for year's. They do continue unfortunately. Ty for this video.

[@maureentinen4135]

Excellent content and very clearly presented. Thank you. However, since the medical name of these hormones and products are so foreign to most of us, it's difficult to recall them as you say them and difficult to spell them to research them. therefore, I recommend that you list them below, or show the names on the screen.

[@heatherhirschMD]

Great idea Maureen! I will definitely start doing that! Appreciate the message

[@patriciapyper4617]

I am on evorol Conti patches can you get a break through bleed on the patches please what does the cream help with please thanks

[@tangomcphearson74]

Thank you so much for such a great helpful video - estrogen is SO important. I'm 68 and a year ago I came down with my first UTI. It wouldn't go away - I'd go through antibiotic treatment, - then get a yeast infection, then my UTI would come back and the cycle started all over again. I ended up in horrible pain in the ER. and catheterized for 5 days. I was finally put on Estradiol cream and i thankfully have not had another one. UTI's are the worst. TY for talking about these things. The sad thing is, right after I got rid of the UTI, I developed Lichen Sclerosus - I feel sure this may have been brought on by the lack of estrogen - and UTI. It does not run in my family - so it is not genetic.

[@christinetavano7807]

I'm 68, and I really need help..I live here in Alabama, so can you please tell me where to go to get help please help me!!

[@tlc6756]

@@christinetavano7807 I would consider natural progesterone (either oral drops taken by mouth, or a cream that can get into bloodstream by rubbing into wrists/feet/behind knees). It's helped lubricate me as if I'm 20! I'm 59 and have been postmenopausal for 12 years. My vaginal tissues inside feel healthier too. Remember to get natural progesterone, not Progestin. Progestin is synthetic and can cause serious problems/clots/stroke. You still have to be careful with natural progesterone and not take too much but I've never had any problems and have used it for 3 years straight (12 yrs ago... when first entering menopause...it took away practically all my menopausal symptoms...I only had a few warm flashed...no hot flashes!), and also for the last 6-7 months. It also can increase libido and relaxation/ mood. Talk to a natural hormone Dr if you can, but I buy mine online (no prescription needed). I find that the oral "micronized progesterone" is the best (there are several brands).

[@tangomcphearson74]

@@christinetavano7807 Christine, make an apt with a gynecologist OR a urogynecologist and tell them you want to be put on Estradiol Vaginal estrogen. IF they say no, ask them WHY when there is literally an almost 0 percent chance of developing breast cancer from the use of vaginal estrogen. Go into that apt with knowledge (watch videos about this topic as well as research articles. IF they STILL tell you no, -move on and try another DR. and remember - women should NOT have to FIGHT to get better female health care.

[@katinamarkham3519]

@@tlc6756hello where and what exact names of the natural progesterone do you purchase please?

[@gymchick1]

I really enjoy your videos❤ Thank you for all of the detailed explanations. I am in perimenopause, and I’ve had numerous symptoms, not knowing that I was in perimenopause… Now that I know, I am soaking up as much info as I can. You’ve been so helpful. I was literally thinking today about starting the vaginal cream because my doctor prescribed it, but I was so confused and worried about it. You literally answered all of my questions.

[@patsieThompson]

Talk about the lining of the uterus menopause

[@KS-op5hb]

May I ask, is the pill form ospemifem safe for hormone positive cancer survivors or should I stick w/ the creams? Is there a 2024 version of this video w/ any updates

[@joannepigliavento7930]

My GP prescribed 1/2 gram 2 x per week. I am in week 7 and have had minimal relief. 😢

[@LoveABun]

Dosing is typically 1 gram, not 1/2 gram. One gram is what the pharmaceutical companies that make vaginal estradiol cream used as their dose in clinical trials! Just increase your amount to 1 gram and don’t tell your doctor. You can also put a pea sized amount of cream on the outside if you have vulvar dryness and irritation, and some on the urethra if you have urinary symptoms.

[@annlopinto2797]

I just started 2 weeks ago

[@50hellkat2]

Such good information. Thanks

[@patriciapyper4617]

Do you get side effects post menopause please thanks

[@yolieb5627]

Thank You!, So Glad I Found You.

[@miamichaels5999]

Excellent and informative video. Been going through the issues you have described in the video and feel hopeful again. Thanks!

[@heatherhirschMD]

Glad to hear it!

[@marthaharvey8499]

Back in the day, pre menopause , I always have severe leg pain, heaviness and discomfort on my legs the first two days of my period. Now in menopause, I was prescribed Estradiol vaginal cream for VA, I am in my 3rd week, but two to tree days after the day of application I have the same feeling in my legs I had when I still had my period. Anyone has this experience and question for the doctor, can I use a smaller amount, just externally but more often, like every other day? I think I read that estradiol vaginal cream reaches a pick in the tissue the first 8 hours after application and then drops, just like estrogen drops when you have your period. Any comments will be appreciated!

[@everhappy6312]

Dr. Barbie Taylor on Menopause Taylor is amazing at talking about the menopause and other things.

[@annlopinto2797]

How long do I stay on estradiol

[@pamelak7924]

That's a real good question I'd ask your doctor

[@LoveABun]

Vaginal estrogens are to be taken for a lifetime to treat GSM. If GSM goes untreated, it will progress and result in severe atrophy, tissues shrinking and disappearing, pain from burning, chronic UTIs, etc… really bad stuff. Never stop it!

[@swilson5102]

What is the oral medication or serum you mention?

[@ginaprentice6533]

Thank you for this super informative video! I’m 47 and starting to notice these symptoms. My doctor already prescribed the cream. I’m so relieved and reassured to have all these insights from you, in addition to the support of my physician.

[@soy_sweet99]

I’m almost 46 and have these symptoms and begged my doctor and now finally got my estrogen cream

[@Sirie7206]

Me too!

[@emmafannon6479]

Can I use New Eve’s Vulva Balm Cream in conjunction with my prescription Estradiol Vaginal Cream?

[@Nikela1978]

Thank you so much for this. I recently had a tvh in March and this is so informative.

[@heatherhirschMD]

Wonderful. I’m so glad that you found it helpful

[@2006marsha]

You are a God send Dr. Hirsch. 🙏🏻

[@Silverqueen68]

Great information n understandable you answered all my questions in this video except two. So can I ask with estrogen crème will this help the perimenapausal odor n will it help with hot flashes?