Tuesday, September 26, 2023

How Do You Apply Estrogen Cream To The Urethra

Atrophic Urethritis And Urinary Incontinence

How Do I Use Estrogen Cream

Lower urinary tract symptoms are common however, it is important to acknowledge they are attributed to underlying mechanisms that vary widely.1 While urinary incontinence is particularly disabling and distressing in the elderly, women in reproductive and early postmenopausal years may also experience this condition and suffer unnecessarily.

Overactive Bladder , caused by uninhibited detrusor muscle contractions, or detrusor overactivity, is the usual cause of incontinence in the geriatric population.1 While most cases of OAB are idiopathic, neurologic conditions such as dementia, stroke, Parkinsons disease, and multiple sclerosis amplify the condition.11 Of note, a form of OAB with impaired contractility, characterized by urgency, frequency, a weak flow rate, and urinary retention, among other signs and symptoms, may mimic stress incontinence.12

Stress Incontinence is the most common cause of incontinence in women who are in the reproductive years or early postmenopausal years.1 It is defined as urine leakage due to abrupt increases in intra-abdominal pressure on exertion, sneezing, coughing, laughing, bending, or lifting without the presence of detrusor activity.1,12,13

Tips For Applying Estrogen Cream

Although the application is very quick and simple there are a few ways you can ensure maximum absorption of the cream and therefore the best results.

Applying the cream at close to the same time each day is recommended. And it is best to apply cream when the skin is clean, for example after a shower, as this allows the cream to absorb better.

It is also recommended to rotate application sites, meaning that you dont apply the cream in the same spot each day. This is a good idea for two reasons. Firstly to avoid any irritation in a particular area. And secondly to avoid over saturation and ensure proper absorption into your system.

If you are new to using the cream or are changing products you should always try a patch test first to make sure you do not have an allergic reaction to any of the ingredients. To do this take a small amount of the cream and apply to a small area of the skin. If no reaction has occurred within 24 hours you should be safe to use the cream as directed.

Finally, it is important to wash your hands after application so as not to transfer the hormones to anyone else.

Uti And Menopause: Estrogen May Improve Recurrent Uti

For many people, UTI and menopause go hand-in-hand. But why is post-menopausal UTI a thing? Can estrogen help for recurrent UTI? And is estrogen cream safe?

We get a lot of questions about hormones, hormone therapy and the possible connection to recurrent UTIs.

Many people who reach out to us have noted they experience UTI symptoms at certain times of their menstrual cycle or that the frequency of UTIs increased at the onset of menopause. Others found starting or stopping the contraceptive pill had an impact.

So is there a link between hormones and recurrent UTI, and can we do anything about it?

Jump To Section:

  • UTI and menopause: The vaginal and urinary microbiomes. > > > >
  • How a healthy vaginal microbiome impacts recurrent UTI. > > > >
  • Recurrent UTI and menopause may be linked by estrogen levels. > > > >
  • Estrogen vs. antibiotics for UTIs. > > > >
  • How estrogen impacts the bladder. > > > >

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What Should I Watch For While Using This Medication

Visit your care team for regular checks on your progress. You will need a regular breast and pelvic exam. You should also discuss the need for regular mammograms with your care team, and follow their guidelines.

This medication can make your body retain fluid, making your fingers, hands, or ankles swell. Your blood pressure can go up. Contact your care team if you feel you are retaining fluid.

If you have any reason to think you are pregnant, stop taking this medication at once and contact your care team.

Tobacco smoking increases the risk of getting a blood clot or having a stroke, especially if you are more than 35 years old. You are strongly advised not to smoke.

If you wear contact lenses and notice visual changes, or if the lenses begin to feel uncomfortable, consult your eye care specialist.

If you are going to have elective surgery, you may need to stop taking this medication beforehand. Consult your care team for advice prior to scheduling the surgery.

How Do You Treat A Urethral Caruncle


Treatment isnt necessary unless the growth is causing uncomfortable symptoms. However, if your urethral caruncle is having a negative impact on your comfort or quality of life, your healthcare provider may recommend treatment.

The most common urethral caruncle treatments include:

  • Topical estrogen cream. Applying this cream helps restore your estrogen levels.
  • Anti-inflammatory medication. Your healthcare provider may also recommend a topical anti-inflammatory cream, such as a corticosteroid, to ease swelling and irritation.
  • Urethral caruncle removal. If nonsurgical options dont work, a surgeon can remove the growth under local anesthesia, sedation or general anesthesia. Its important to note that, even with surgical removal, theres still a chance for urethral caruncle recurrence .

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Vaginal Estrogen Cream: Why And How To Use It

When hormones dont work like theyre supposed to, they can cause a variety of problems. Correcting these hormone levels is tricky and may include treatments that range from dietary changes to surgery. Another potential treatment for hormonal issues is a vaginal estrogen cream. Read on to discover how it works, how to use it, and any side effects you should watch out for.

Why Use Vaginal Estrogen Cream

There are many different treatments for symptoms of menopause and low estrogen available today. You could change your diet or lifestyle or even supplement with different products.

Women who are going through menopause experience a dramatic shift in their hormones. As the hormones change and stop monthly periods, they can also create some unpleasant vaginal symptoms, such as:

  • Vaginal dryness
  • Pain during sex due to lack of natural vaginal lubrication
  • Painful urination
  • Sudden and frequent need to urinate

Hormones affect vaginal health. During menopause, these same hormones shift, changing vaginal health as well.

Vaginal estrogen cream is used to treat the above-mentioned symptoms, as well as others. It should only be used as prescribed by your doctor. If you have any of the above symptoms and are going through menopause, talk to your doctor. They may want to run a few tests before prescribing a vaginal cream to help alleviate these symptoms.

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How Estrogen Fights Urinary Tract Infections

The female hormone estrogen may protect against urinary tract infections in postmenopausal women by improving two of the body’s defense mechanisms, a new study found.

The researchers looked at the effects of estrogen supplements in healthy postmenopausal women, and found that the hormone helped trigger the production of body’s natural antimicrobial proteins in the bladder.

The hormone also strengthened urinary tract tissue by tightening the surface layer of the bladder cells, which protects the underlying cells from infection, according to the study published today in the journal Science Translational Medicine.

Urinary tract infections are usually caused by E. coli bacteria, and are more common in women than men. Some patients suffer from recurrent infections that return every few months.

In postmenopausal women, the low levels of estrogen are thought to have a role in recurrent infections by causing changes in the urinary tract that make it more vulnerable to infection.

It is thought that using estrogen supplements, in the form of a low-dose cream applied to the vaginal area, may prevent recurring UTIs, said Dr. Margery Gass, the executive director for The North American Menopause Society and a gynecologist at Cleveland Clinic, who was not involved in the study. She noted that the percentage of women who develop recurrent UTIs after menopause is very small.

They found that in 12 participants, levels of antimicrobial proteins increased after the estrogen supplements.

Uti And Menopause May Be Directly Linked To Lactobacillus In The Vaginal Microbiome

Estrogen for mature skin: Emepelle?| Dr Dray

What happens after menopause? Studies have shown that post-menopausal females tend to lose Lactobacillusand their vaginal microbiomes become more diverse2-4.

This change can be influenced by Hormone Replacement Therapy .

Studies have shown that post-menopausal females who have been on HRT for years tend to have more of a Lactobacillus dominant community compared to females of the same age not on HRT.

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How To Apply Bi

Estrogen cream is typically applied once per day unless your provider directs otherwise .

If your Bi-Est cream includes Progesterone, its typically best to apply in the evening. Anytime up until the hour of bedtime should work.

If your Bi-Est doesnt contain Progesterone, you can apply in the morning or evening, depending on what works best for you.

Bi-Est application sites include:

To prevent breast sensitivity and pain, we do NOT recommend applying Bi-Est to the:

Before applying, wash and dry your hands.

If your Bi-Est cream is in a topi-click container, you can apply directly to your skin from the container. If your Estrogen cream is in a pump bottle, make sure the pump is activated and the container is distributing a full dose. If your Bi-Est is in a pre-filled syringe or packet, its likely measured at a full dose already .

Once youve applied, avoid swimming, bathing or taking a shower for at least forty minutes, as this can wash away the hormone cream and interrupt absorption. Your HRT will be less effective is this happens.

You should also avoid exercising or working up a sweat for at least two hours to ensure better absorption.

Important Safety Information And Indication

Using estrogen alone may increase your chance of getting cancer of the uterus . Report any unusual vaginal bleeding right away while you are using Premarin Vaginal Cream. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus. Your healthcare provider should check any unusual vaginal bleeding to find out the cause.

Do not use estrogens with or without progestins to prevent heart disease, heart attacks, strokes, or dementia .

Using estrogen alone may increase your chances of getting strokes or blood clots. Using estrogens with progestins may increase your chances of getting heart attacks, strokes, breast cancer, or blood clots.

Using estrogens, with or without progestins, may increase your chance of getting dementia, based on a study of women 65 years of age or older.

Estrogens should be used at the lowest dose possible, only for as long as needed. You and your healthcare provider should talk regularly about whether you still need treatment.

Premarin Vaginal Cream should not be used if you have unusual vaginal bleeding, have, or had cancer, had a stroke or heart attack, have or had blood clots or liver problems, have a bleeding disorder, are allergic to any of its ingredients, or think you may be pregnant. In general, the addition of a progestin is recommended for women with a uterus to reduce the chance of getting cancer of the uterus.

If you take thyroid medication, consult your healthcare provider, as use of estrogens may change the amount needed.

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What Questions Should I Ask My Healthcare Provider

Learning all you can about your situation can help you make informed decisions about your health. If your provider thinks you have a urethral caruncle, here are some questions you might want to ask:

  • Do I need a biopsy to confirm my diagnosis?
  • When will I know the results?
  • Will I need to undergo other types of testing?
  • What are my treatment options?
  • Will surgery be necessary?

A note from Cleveland Clinic

A urethral caruncle is usually not a cause for concern, and treatment is typically successful. But prompt diagnosis is essential for your long-term health. Because these growths can mimic other conditions such as urethral cancer its important to see your healthcare provider as soon as possible.

Last reviewed by a Cleveland Clinic medical professional on 03/18/2022.


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy

Uti And Menopause: The Vaginal And Urinary Microbiomes

Where To Apply Estrogen Cream

The relationship between UTI and menopause has a few layers. First, lets just confirm something many people are not yet aware of

Contrary to long-held beliefs, urine is not sterile. The bladder has its own unique microbiome, even in a healthy state.

To be fair, the discovery of the female urinary microbiome was fairly recent, but the consequences of this research are already making ripples through everything we thought we knew about UTIs.

When we mention that the bladder has its own microbiome, most people think of what they have learned about the gut microbiome. This conjures images of a complex network of millions of bacteria all living and working together.

The bladder is very different from the gut its function is to store and remove waste products.

It is a low biomass niche, meaning instead of billions of bacteria, a healthy persons bladder may only have a few thousand. And instead of a community of different bacteria, a healthy person tends to have one or two dominant bacteria.

You could think of the gut microbiome kind of like a rainforest, filled to the brim with different species of plants and animals. If the gut is a rainforest, the bladder is a desert. It has a microbiome, but its low biomass, meaning there are relatively few bacteria to be found there.

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What Can I Expect If I Have A Urethral Caruncle

If your healthcare provider suspects that you have a urethral caruncle, they may run tests to confirm the diagnosis. This step is important for ruling out other, more concerning conditions, such as cancer.

Unless the growth is causing pain or problems, treatment isnt necessary. If you have pain, irritation or other symptoms, your provider will likely prescribe topical estrogen cream and anti-inflammatory medications.

If nonsurgical options dont work, then your healthcare provider may recommend surgery.

Where To Apply Compounded Hormone Creams

Where do I apply my compounded hormone creams? Your doctor or compounding pharmacist should provide you with directions on how to use your compounded hormone creams. The following is a list of generally accepted sites for application: Estrogen: wrist, forearm, under bicep, upper shoulder, inner thigh, behind knee, on rear end

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The Best Areas Of The Body To Apply Estrogen Cream

The best areas to apply the cream are areas of the body with the thinnest skin and least fat. It is also advisable to apply the cream as thinly as possible to ensure the maximum surface area is available for absorption.

To see the effects of your estrogen cream working faster, good areas to apply estrogen cream include the inner forearms, the inner thighs, the inner upper arms, the backs of the knees, the neck and the sides of the ribcage. If you are applying cream to the forearms you may find you dont even need to dispense to the cream onto your hand first but can just rub your forearms together. The main idea is to avoid applying estrogen cream to the fatty areas of the body including breasts or the tummy.

How Should I Use This Medication

Information on Estrogen Cream

A patient package insert for the product will be given with each prescription and refill. Read this sheet carefully each time. The sheet may change frequently.

Talk to your care team regarding the use of this medication in children. This medication is not approved for use in children.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

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How To Apply Estrogen Cream With Your Finger

Estrogen: A cream that treats symptoms of menopause, vaginal dryness, and painful menstruation. In addition, it treats urinary incontinence, such as the inability to control urine flow. Thus, most women go with it as an option. Do you have any of these issues? Need to know how to apply it to your vaginal area? Just get into the blog.

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What May Interact With This Medication

Do not take this medication with any of the following:

This medication may also interact with the following:

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

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Estrogen Cream Side Effects

Because estrogen cream is a form of hormone treatment, it has the same possible side effects as other hormone treatments.

The hormones in our bodies are in a constant balancing act. Simple things like changes in diet can throw them off. If youre taking estrogen cream for a particular ailment, it can help balance your hormones. But if you use it for too long or use too much at a time, you can put your hormones out of balance again.

The main complications of estrogen therapy are deep vein thrombosis, pulmonary embolism, coronary heart disease, and endometrial and breast cancer. But the low dose of estrogen in local vaginal creams helps to avoid these complications. Low-dose estrogen cream may still cause some side effects such as:

  • Breast pain/tenderness

Where Do You Apply Estrogen Cream

Julva by Dr. Anna Cabeca

Once you have decided to use estrogen cream it is important to make sure you apply it correctly so as to obtain the maximum benefits. Incorrect application can mean your body will not absorb the estrogen and you will not see the full effects.

Applying estrogen cream directly to the skin, rather than taking estrogen orally, allows the estrogen to be absorbed directly into the bloodstream. Thus bypassing metabolism by the liver and gut.

Applying an effective OTC estrogen cream is quick and easy. Simply dispense one pump either onto your hand or directly onto the area you have chosen and spread as thinly as possible over the skin.

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