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The Best Estrogen Cream for Vaginal Dryness? It Might Actually Be Estriol!

My doctor prescribed me estradiol and that didn’t work, so why would this?! We hear this ALOT! Before we answer that question, the first thing we need to understand is estrogen itself...

Understanding Vaginal Estrogen Creams

There are three types of estrogen - estrone, estradiol, and estriol, and they each serve different functions. There are so many different creams for vaginal atrophy on the market, and many of these are estrogen creams for vaginal atrophy… but many of us don’t know how these estrogens differ.


Estrone sits at the middle of the pack, strength-wise, and it is prominent during our teen years, until proper cycling begins. Estrone is produced by our fat tissues and can be converted into estradiol, which is the strongest form of estrogen in our bodies.


Estradiol is by far the most powerful of the three estrogens. Estradiol has so many benefits for the body we will list just a few biggies here: bone density, in the cardiovascular system helping raise HDL (high-density lipoproteins), the beneficial cholesterol, and memory and recall. Estradiol likes to grow things…like the uterine lining and breast tissue.


Estriol is the most gentle of the estrogens. Estriol circulates in low levels in menstruating females. It becomes much higher during pregnancy.

Why Estriol Helps the Epidermal Layer

But, this isn’t the whole story when it comes to estriol. Aside from being a gentler form of estrogen, making it more suited to low dose, topical estrogen cream for atrophy, hormone replacement. It also has a unique feature—Estriol is especially helpful for skin integrity and mucous membranes. This is what makes it the best type of cream for vaginal atrophy—it is uniquely suited to skin repair, thus helping the delicate tissues of the vulva and surrounding area!

What Does This Have to Do with My Vagina?

Similarly, this is what makes it one of the best creams for vaginal dryness—as the skin cells are rejuvenated, there is:

  • Less itching.
  • Less tearing.
  • Less pain.
  • The mucous membranes have a better ability to both retain moisture.

Many women using Silky Peach also report an increase in their own natural lubrication.

Now, before you think— ‘well, this isn’t a vaginal atrophy cream, this helps the vulva!’ Remember, there are a ton of estrogen receptors in this area that basically act as carriers. External application of Silky Peach vaginal atrophy cream to the vulva works to help internal issues; the estriol hops onto a blood cell (like a little bus) and gets off at the receptor stop where it is needed.

The Science of Estriol

During menopause, estrogen levels decline, leading to various symptoms such as hot flashes and vaginal dryness. Estriol supplementation in menopausal women provides help for vaginal atrophy by alleviating these symptoms.

It does this by binding to estrogen receptors, particularly in the reproductive and genitourinary tissues. Its impact on the skin and mucous membranes is attributed to its ability to enhance collagen production and promote tissue hydration.

Estriol's binding to specific receptors triggers cellular responses, influencing gene expression and ultimately contributing to the maintenance of skin elasticity and mucosal health.

How Estriol and Estradiol Creams for Vaginal Atrophy Compare

We’ve already looked at the differences between estriol and estradiol as compounds, but what about as creams for vaginal atrophy? Estriol seems to be absorbed locally and works better than estradiol which is more often used for systemic delivery with vaginal health thrown in.

Yes, you read that right—estradiol will have a much greater systemic effect than estriol due to the fact that it is a more potent form of estrogen. And, whilst that means it can help with other areas of estrogen decline, it also means it can come with significantly more side effects, such as hot flashes, mood swings, and period-like cramping.

Why Estriol Is OTC

Another common question we get is ‘how come I can get this from you? I thought it had to be prescribed?’

Whilst some vaginal atrophy creams ARE prescription only, this refers to creams that have multiple hormones—known as compound creams, or ones that contain estradiol. Estriol is not as powerful as estradiol and so can, in small amounts, be safely used by many women, making it the perfect choice to help vaginal atrophy.

How Do We Get Bioidentical Estriol Cream from Soy and Yams?

Unlike hormones made from horse pee—like those in the 80’s… bioidentical estriol cream hormones are typically made from plants. Diosgenin is extracted, and then it is molecularly altered to be bioidentical to the hormones produced in your body.

This means your body is getting the same chemical messengers it would produce on its own, unlike say, hormones from horse urine, which contain hormones for well… horses.

Different Creams for Vaginal Atrophy

Now, an estrogen base is not the only option for vaginal atrophy creams—there are also creams that contain:

  • Vitamin E
  • Hyaluronic acid
  • Moisturizers
  • And even herbal helpers like slippery elm

These can all be really helpful at increasing moisture and helping with things like itching and dryness—but, they are not going to be able to help the underlying cause, which is a decline in estrogen.

Ultimately, the only thing that can help increase the amount of estrogen, is estrogen supplementation; adding a small amount of estrogen vaginal cream, like Silky Peach, can gradually resupply the tissue with the estrogen it needs.

However, if they do not contain hormones, they can be used alongside Silky Peach Cream to help maintain overall skin health of the vulva and vagina.