Oral and Vaginal Estrogen with vaginal dryness

Sorry so long, but I know this is the best place for answers! I can't seem to figure this one out on my own.

I have been taking oral Estradiol since my surgery in April of this year. Almost two months ago, I began using Estrace vaginal estrogen due to dryness which caused a bladder infection. My doctor told me I could double the amount of Estrace if I felt that I needed it, but to give it about a month to see how the prescribed dosage was doing. Everything was fine. The Estrace seemed to completely take care of the dryness. Life was great. Since I want to get off of oral estrogen soon (my mother had very aggressive breast cancer) I began taking only half of my Estradiol tablets about two weeks ago and the vaginal dryness seems to have come back even though I have continued the Estrace just as before. I know that the NHI study shows that estrogen only does not really cause a rise in the chances of breast cancer, but don't want to take any chances. I have not had any hot flashes or moodiness since cutting the dosage. Could the lower dosage of oral estrogen be causing the vaginal dryness even though it didn't seem to do anything for it at the full dose causing the use of Estrace? Should I up my dosage of oral estrogen or up the dosage of the Estrace as the doctor said I could? Also, I put the Estrace in at night when I go to bed so it can be absorbed overnight, but seems to slip out in the morning when I get up. If I up the dosage of Estrace, should I put it in three nights a week instead of two, so that it gets absorbed as much as possible and doesn't just come back out? Any help with this would be very much appreciated.

Have you tried Vagifem tablets (vaginal)? They are way less messy. I think initially you use them nightly for 2 weeks, then twice/weekly after that. When I used them, I actually found better results using them in the morning - I think the daily activity helped dissolve them and spread the estradiol throughout the tissues.

HI, Thanks for the response. No, I have not tried Vagifem tablets. That will be a consideration, though. The Estrace was working perfectly until I started taking half the oral dose of Estradiol. I guess I will just have to try tweaking one thing at a time. First, I think I will up my dose of the Estrace as I really do want to get off the oral estrogen. Again, thanks. The tablets do sound much less messy, and I could see where it may be better to insert those in the morning as opposed to night time.
Take care.

I'd just like to add a comment about Vagifem.

After my TAH/BSO (exactly one year ago yesterday), I was adamant that I would not go on any kind of HRT for reasons that are complicated. After about five months, I began to have real problems with vaginal dryness that I treated with vitamin E suppositories with a modicum of success.

However, I began to have recurrent bouts of bacterial vaginosis due to the wonkiness of the PH balance in the vagina. I knew that I would keep on being bothered by this until that underlying issue was addressed. My doc recommended Vagifem; I used one suppository at night for two weeks, and I'm now on the maintenance schedule, i.e. twice a week.

I had my 1 year check up yesterday, and my doc, after examining me, said that my vaginal tissues look completely normal and if she didn't know any better, she'd never guess I was menopausal.

I have not had BV since using Vagifem.

Vagifem is a miracle, and it has fully addressed the one menopausal symptom that plagued me. I know that it is not for everyone...it may not be right for you, but if you are looking to come off of oral HRT but still want/need something for vaginal health, it may be worth asking about. I just wanted to relate a true success story.

Thank you so much for responding with that success story. Right now, I am using the Estrace three times a week instead of two. If that doesn't work, I will contact my doctor about the Vagifem. Again, thanks a bunch. It really helps me to hear from people that are going through the same things, not just hear-say. Again, thank you.

You may also want to consider Estring. It's a low dose vaginal ring you insert once every three months. No messy creams or remembering to insert tablets. It took care of my vaginal dryness.

Hope you find something that works for you.