Your Guide to Vaginal Estrogen in Canada

By Dr. Daniela Steyn

author of the international bestselling book: Thrive through Menopause,

Oakville Menopause Clinic, Wellness MD

Genitourinary symptoms of menopause are among the most common and most disruptive changes women experience in midlife. Vaginal dryness, burning, itching, painful intercourse, and recurrent urinary tract infections can significantly affect quality of life. The good news is that localized vaginal estrogen is one of the safest and most effective treatments available, and it is widely used across Canada.

At Wellness MD, we help women understand their options so they can choose the therapy that best fits their needs and comfort level. Below is a clear comparison of the vaginal estrogen products available in Canada including brand names and whether they are bioidentical.

What Does Bioidentical Mean

Bioidentical estrogen is structurally identical to the estrogen your ovaries naturally produced before menopause. Non-bioidentical estrogens are still effective, but their molecular structures differ slightly from human estrogen.

For vaginal therapy, both types work well because the doses are low and the effect is local.

Vaginal Estrogen Options in Canada

1. Vagifem

Type: Estradiol vaginal tablets

Bioidentical: Yes

Dose: 10 micrograms

How it works: A small tablet inserted into the vagina using a disposable applicator

Why women choose it: Clean simple and low mess. Ideal for women who prefer a precise dose without creams.

Common uses: Vaginal dryness painful intercourse urinary symptoms

2. Estring

Type: Estradiol vaginal ring

Bioidentical: Yes

Dose: Releases 7.5 micrograms of estradiol per day for 90 days

How it works: A soft flexible ring placed in the vagina and left in place for three months

Why women choose it: Extremely convenient. No need to remember doses. Provides steady continuous relief.

Common uses: Chronic dryness recurrent urinary tract infections painful intercourse

3. Estragyn Cream

Type: Estrone vaginal cream

Bioidentical: Yes estrone is a naturally occurring estrogen

How it works: A cream applied inside the vagina using a measured applicator

Why women choose it: Flexible dosing and helpful for women who need both internal and external relief

Common uses: Dryness burning itching thinning of vaginal tissues

4. Premarin Vaginal Cream

Type: Conjugated equine estrogens

Bioidentical: No

How it works: A cream applied inside the vagina two to three times per week

Why women choose it: Long history of use and often covered by insurance plans

Common uses: Vaginal atrophy dryness painful intercourse

How Do These Options Compare

Product	Estrogen Type	Bioidentical	Form	Dosing Convenience	Best For
Vagifem	Estradiol	Yes	Tablet	Very convenient	Women who prefer no mess and precise dosing
Estring	Estradiol	Yes	Ring	Most convenient	Women who want set it and forget it therapy
Estragyn	Estrone	Yes	Cream	Flexible dosing	Women needing internal and external relief
Premarin	Conjugated estrogens	No	Cream	Moderate	Women with insurance coverage or long term familiarity

For women who need a different formulation or strength, our trusted compounding pharmacy can prepare a customized option tailored to their needs. Vaginal estrogen supports healthier tissue, improves blood flow, enhances sexual comfort, and helps many women feel more like themselves again. It can also play an important role in maintaining vaginal and urinary health as women age, including reducing the risk of recurrent urinary tract infections and recurrent bacterial vaginosis.

At Wellness MD, we help you choose the option that aligns with your symptoms, preferences, and medical history.

Is Vaginal Estrogen Safe

Vaginal estrogen is considered safe for most women because the dose is low and absorption into the bloodstream is minimal. It is different from systemic hormone therapy and does not carry the same risks. Many women can use it long-term to maintain comfort and sexual health.

Many women are surprised to learn that vaginal estrogen is not only for postmenopause. It can be helpful before menopause as well, especially for women on birth control who experience dryness or discomfort, and for women of any age who struggle with painful sex. At Wellness MD, I prescribe vaginal estrogen as part of a comprehensive medical approach to restoring comfort and confidence. Our Menopause Certified Naturopathic Doctors, Dr Fountain and Dr Matte, are also licensed to prescribe vaginal estrogen and support women through every stage of hormonal transition.

Menopause should not mean living with discomfort. Vaginal estrogen is one of the most effective ways to restore comfort, confidence, and intimacy. Whether you prefer a cream, a tablet, or a ring, there is an option that can fit seamlessly into your life.

Book your appointment today and let us help you feel like yourself again.

Book with Dr. Matte