Hi there.  Yes, you, with the new tube of 0.01% Vaginal Estradiol.  

And I hear you wondering, "how do I use this applicator?"

I'm glad you are here.  

If you don't know me, my name is Dr. Kelly Sadauckas (said-OW-skiss, thanks for asking).  I am a pelvic floor expert here to demystify all things pelvic-related. Today, I will tell you what is the best way to apply vaginal estrogen!

If you're on Instagram, you can watch a fun Reel I made about this topic HERE.  If not, read on, you Very Important Pelvis, you!

Why The Applicator Included with Vaginal Estrogen Stinks

To understand the best way to apply Vaginal Estrogen, you first need to recognize what the instructions say about applying it, and why these are not ideal for most of us.  

The instructions will say to use the applicator to apply the recommended dose (usually 0.5 gram 2-3x/wk), but there are serious issues with this. 

FIRST: ONE APPLICATOR, to put inside your Vag and apply Estrogen 3x/wk, for a month?  Gross.  How do you clean it?  

SECOND: Would you ever apply sunscreen by just "globbing it on" your face in one spot?  NO.  That would never work.  So why do we expect it to work vaginally?  

Naysayers will argue that the vaginal Estradiol softens and disperses in the Vag due to "natural secretions" and heat.  However this is not the case in practice.  An estrogen deficient vag (which is ANY vag in the year postpartum, and all vaginas over 40 years old), will have less secretions, and one with a dysfunctional pelvic floor might have nearly none.  So that "glob" of Estradiol just sits in one place. 

The concentrated Estradiol can actually be irritating to the tissues, and can CAUSE pelvic pain or burning.  Additionally, since it's not dispersed, it might fall out in a glob when you stand up in the morning.  Ugh. 

Why do the instructions say to do it this way?  Because we live in a patriarchal, puritan, world, and the makers of the instructions didn't want us to touch our own bodies, or didn't think that we would want to touch our own bodies, even if it means that we actually get the medicine delivered as intended. 

Luckily, there is a better way to apply the Vaginal Estrogen. 

The Best Way to Apply Vaginal Estrogen

I do recommend keeping the applicator for ONE HOT SECOND, to measure out how much is 0.5 grams.  Do this by filling "1 gram" of Estradiol cream in the applicator, then squirting half of it on your finger.  This is the amount that you will apply 2-3x/wk.  

Now you can throw the applicator away (unless your friendly neighborhood pelvic physio wants it to film social media content about them throwing it away).

With the appropriate amount of Estradiol Cream on your finger (it should look like a pea), place your finger at the labial lip region, insert it into the vaginal canal about 1-inch deep, and rub the cream around to the front and the back, side to side, for 5-10 seconds, until it is rubbed in.  

And you are done!  Now you have actually applied the vaginal estradiol in a useful way, so that the desired tissues receive the medicine, and you are not wasting it!  WOOT!

Tell your friends, and feel free to comment below with additional questions or tips!  We're all in this together!

XOXO
Dr. Kelly