This might be a question for Wendy, but perhaps David has thoughts as well. What do you think of vaginal Estradiol cream for post menopausal women with prolapse (uterine, cystocele, and/or rectocele) and vaginal atrophy? Risks vs benefits? Any herbal/natural alternatives you recommend? Thank you!

Wendy may have a better grasp on this, but from what I have read estradiol creams are not really effective for prolapse, but do help vaginal atrophy. So do progesterone creams and Fennel seed creams DALLAS – Aug. 15, 2023 – Vaginal estrogen cream, which is commonly prescribed to help women after surgery for pelvic organ prolapse (POP), did not prevent a recurrence of the condition, according to results of a multicenter clinical trial led by UT Southwestern Medical Center. However, the medication did reduce symptoms of vaginal atrophy. The findings, reported in JAMA, could lead to new ways to improve outcomes of prolapse repairs, the study authors said. “Our results would argue against routine prescription of vaginal estrogen to optimize vaginal tissue for prolapse repair, a practice that is recommended by some experts,” said study leader David Rahn, M.D., Professor of Obstetrics and Gynecology at UT Southwestern.