Vaginal Estradiol & Menopause Care
Vaginal Estradiol: A Gentle, Effective Tool for Menopausal Bladder and Vaginal Symptoms
As women move through perimenopause and menopause, changes in estrogen levels can significantly impact vaginal and bladder health. Yet many women are told their symptoms are “normal” — and left without real solutions.
One evidence-based option that deserves more attention is vaginal estradiol.
What is vaginal estradiol?
Vaginal estradiol is a topical estrogen therapy applied directly to the vaginal tissue. Its goal is to improve the health of the genitourinary tissues affected by declining estrogen levels, without significantly increasing estrogen throughout the body.
Because it acts locally, it’s often well-tolerated and appropriate for women whose symptoms are primarily vaginal or urinary in nature.
Vaginal estradiol and bladder symptoms
Estrogen plays an important role in bladder and urethral health. As estrogen declines, some women experience:
Urinary urgency
Increased frequency
Overactive bladder symptoms
A reduced ability to “hold it”
Research has shown that vaginal estrogen therapy can:
Increase bladder capacity
Reduce spontaneous bladder muscle contractions
Improve urgency and frequency
In fact, some studies suggest that vaginal estrogen can be as effective as antimuscarinic bladder medications in postmenopausal women — without the systemic side effects often associated with those drugs.
Vaginal dryness, discomfort, and intimacy
One of the most common — and under-reported — symptoms of menopause is vaginal dryness. Low estrogen levels can lead to thinning of the vaginal tissue, reduced lubrication, and increased irritation.
Vaginal estradiol helps:
Restore natural lubrication
Improve tissue elasticity
Reduce burning, itching, and pain with intercourse
For many women, this leads to improved sexual comfort, arousal, and overall quality of life.
Who can prescribe vaginal estradiol?
An important and often overlooked point: vaginal estradiol can be prescribed by both physicians and naturopathic doctors. This allows for collaborative, patient-centred care — especially when symptoms overlap between pelvic health, hormonal changes, and quality-of-life concerns.
How pelvic physiotherapy fits in
At Makewell Health, we often combine vaginal estrogen therapy with pelvic floor physiotherapy. While estrogen supports tissue health, pelvic physio addresses:
Bladder habits and urgency strategies
Pelvic floor muscle function
Pain, tension, or weakness contributing to symptoms
Together, this approach supports both the structure and function of the pelvic floor.
The takeaway
Vaginal estradiol is a safe, effective, and underutilized option for managing vaginal and bladder symptoms during perimenopause and menopause. You don’t need to wait until symptoms become severe — and you don’t need to accept discomfort as “just part of aging.”
If you’re experiencing vaginal dryness, bladder changes, or discomfort with intimacy, a personalized plan that includes pelvic physiotherapy and hormonal support may make a meaningful difference.
If you’d like help exploring your options, our team is here to support you — every step of the way.
