It’s not the craziest idea we’ve ever heard. Vaginal estrogen cream can help plump up and moisturize the vagina in perimenopause and post-menopause, so could it do the same for your face? We asked Dr. Shafeena Premji, a Menopause Society-certified family physician in Calgary, and Dr. Sandy Skotnicki, a Toronto-based dermatologist, for their insight. Here’s what they told us.
What is vaginal estrogen?
Estrogen is one of the hormones prescribed as menopausal hormone therapy. It plays a key role in ovulation and menstruation, and also affects many parts of the body including the heart, bones and brain.
Some formulations of estrogen, such as pills taken by mouth, or gel or patches applied to the skin, are absorbed into the bloodstream and have effects throughout the entire body. These are referred to as “systemic therapy.”
Vaginal estrogen, on the other hand, is considered “local therapy.” It is applied to the vaginal area in low doses and acts directly on the tissues. There are several Health Canada-approved vaginal estrogen products, including creams, a flexible ring, a tablet and a softgel insert, all of which are available only by prescription.
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Compounded products, which are individually mixed and prepared by a healthcare professional are available, but Premji recommends avoiding them. Compounded hormones are not approved by Health Canada, leading to potential concerns about safety and efficacy.
What is vaginal estrogen typically used for?
Vaginal estrogen increases blood flow to the genital area and relieves symptoms such as vaginal dryness, thinning, pain and frequent urinary tract infections. These complaints are collectively referred to as the genitourinary syndrome of menopause, which develops because of falling estrogen levels. Vaginal estrogen can also be used postpartum, when similar symptoms often occur. (There are also effective non-hormonal options.)
If used in low doses–one manufacturer recommends a blueberry-sized amount of cream equivalent to half a gram twice a week—vaginal estrogen is minimally absorbed into the bloodstream. So, unlike systemically absorbed estrogen therapies, low-dose vaginal estrogen does not seem to be associated with risks such as stroke, blood clots and uterine cancer.
Can it do anything for your face?
The data is limited, says Premji, but small studies suggest possible benefits. One study found that applying vaginal estrogen cream to the face increased skin thickness and improved fine wrinkles—but it made no difference in terms of roughness, looseness or pigmentation.
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Skotnicki, who tackles skincare misinformation on her podcast, Skin to It, agrees that there is a lack of robust scientific data around using vaginal estrogen cream on the face. She says that physiologically, it makes some sense that it could be helpful in perimenopause and post-menopause.
There are estrogen receptors in the skin, she explains, and decreasing levels of estrogen lead to significant and rapid thinning of skin, loss of elasticity and fine wrinkles.
“We know that vaginal estrogen increases the thickness of the mucosa in the vagina, so why wouldn’t it do the same in other places?” she says. “The question always is safety.”
So is it safe?
It’s difficult to say, because limited research has been done to answer this question. Small studies appear to show that absorption into the bloodstream from skin is minimal, which suggests it is unlikely to be dangerous, but Premji cautions that there’s no data about what would be a safe and appropriate dose to apply to the face.
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“If someone’s asking for it, I would review the data with them and say this is really not well studied and they would need to make an informed decision based on their risk tolerance as well as what the data is showing,” she says.
Another caveat from Skotnicki: it’s possible that applying estrogen cream to the face could result in dark patches—a condition called melasma which is linked to increased estrogen levels.
What can you try instead?
Aging is influenced by both intrinsic and extrinsic factors. “Most of our aging is extrinsic… from the sun and smoking and pollution, which estrogen isn’t going to help as much with,” says Skotnicki. If you smoke, absolutely quit. And always wear sunscreen.
Instead of vaginal estrogen cream, she says, there is convincing data to recommend retinol, vitamin C and peptides.
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Above all, Skotnicki says, her best advice is to get answers from a menopause specialist in person, not from TikTok.
“It’s just hard to get a whole grasp of all the information you need to know in 30 seconds.”
