For some ladies, starting an estriol cream comes with a painful burning and stinging sensation that makes them want to hurl the whole thing off a cliff. So, what gives? It can be a surprise, discovering that even something that is meant to help the look and feel of the skin takes a little time to work.

Red, Raw, and REALLY Painful...

To explain this, let's leave our tender bits aside for the moment and think instead about your nose. Recall a time when you had a cold — one of those annoying lingering colds that had your nose running endlessly for days. Endless nose wiping results in your nose getting sore and red and tender to the touch.

In this scenario, the skin has been rubbed raw and the cells in the dermis now have lots of tiny micro-tears. The skin is vital for keeping pathogens and bacteria from getting in, so there is always an inflammatory response to try and heal the micro-tears.

Back to your red-raw-Rudolph nose. You put some lotion on and — bam! Nose burning that makes you cry (literally and figuratively). The lotion will seep into the micro-tears on the skin and, even though it is there to comfort that tender skin, the combination of ingredients in the cream will result in a stinging sensation.

Micro-tears & Menopause

Well, so it is with the vaginal and vulvar skin. Without estrogen, particularly estriol, there are significant changes in the vaginal and vulvar skin.

Estrogen is associated with suppleness and hydration. When estrogen levels fall, the vulvar and vaginal skin can become thinner, dryer, less elastic, and more fragile. This combination of thinning and dryness creates a higher susceptibility to small breaks in the skin known as micro-tears.

These tiny breaks can make the area feel more sensitive to everyday friction, contributing to burning and itching sensations.

What Are Some Options?

One is to give up… but, y'know, don't do that.

The second option is to work out how to get the estriol in the cream to where it is needed. Some women have had great success with a more gradual approach. By applying the cream to the outer labia, the skin plumps up and begins to feel better. The estriol in the cream gradually distributes elsewhere to make the inner labia skin feel plumper and stronger.

Any skin that is very raw may take several weeks to gradually feel more comfortable and appear more conditioned, so patience and consistency really do matter here.

There is a third option: discuss the situation with your doctor. If initial discomfort is significant, a conversation with your healthcare provider about options may be helpful before continuing. Once you're comfortable, regular cream application can become part of your ongoing feminine care routine.

A Continuum

The degree of vaginal and vulvar tissue changes associated with estrogen decline is on a continuum, and we know that our ladies are not all in the same place. Some are just beginning to feel dryness, others can barely wear clothing because it hurts so much — then of course, there is everything in between.

We hope our educational info helps you understand what is happening to your body!

If you experience considerable burning, swelling, or pain, it could be a sign of an allergic reaction. Test a small amount on the inner wrist to determine if it's an allergy. If you have a similar response on your wrist, it's likely an allergic reaction, so discontinue use.