Sample Trade Names for Estrogen Used to Treat Vaginal Dryness
For vaginal dryness treatment, the most commonly available estrogen products include Premarin Vaginal Cream (conjugated equine estrogens), Vagifem (17β-estradiol vaginal tablets), and estradiol vaginal rings, with Premarin being one of the oldest and most widely recognized formulations. 1, 2, 3
Specific Trade Name Products
Vaginal Creams
- Premarin Vaginal Cream contains conjugated equine estrogens derived from pregnant mare urine and is FDA-approved for moderate to severe dyspareunia and vaginal atrophy 4, 2, 5
- The typical dose is 1.25 mg conjugated equine estrogen cream, though lower doses administered twice weekly (0.625 mg) have also proven effective 6, 2
- Synthetic conjugated estrogens A cream is another formulation that has been FDA-approved for vaginal atrophy, administered as 1 g twice weekly 6
Vaginal Tablets
- Vagifem contains 25 μg of 17β-estradiol in tablet form and demonstrates equivalent efficacy to Premarin cream for relieving vaginal dryness, soreness, and irritation 2, 3
- Vaginal tablets show superior patient acceptance compared to creams, with lower withdrawal rates (10% versus 32%) and more favorable patient ratings 2, 3
Vaginal Rings
- Estradiol vaginal rings provide sustained-release formulations for continuous delivery and effectively treat vaginal dryness, itching, discomfort, and painful intercourse 7, 8
- An estradiol-releasing vaginal ring was shown to be safe and improve vaginal atrophy in postmenopausal breast cancer survivors on aromatase inhibitor therapy 7
Injectable Formulations
- Estradiol Valerate Injection is an intramuscular estrogen formulation used after menopause to reduce moderate to severe hot flashes and treat moderate to severe vaginal dryness, itching, and burning 1
- This injectable form should be administered deeply into the upper, outer quadrant of the gluteal muscle 1
Important Clinical Considerations
- Vaginal tablets (Vagifem) demonstrate a more localized effect without appreciable systemic estradiol increases compared to vaginal creams, resulting in less endometrial proliferation or hyperplasia 2, 3
- For women specifically treating only vaginal symptoms, topical vaginal products are preferable to systemic formulations like injections 1
- Estriol-containing preparations may be preferable for women on aromatase inhibitors, as estriol is a weaker estrogen that cannot be converted to estradiol 7, 8