Estradiol vaginal cream is a medication used to treat vaginal irritation, dryness, and pain during sex caused by menopause. It is an estrogen hormone that reduces these symptoms by replacing the estrogen that the body is no longer producing. The cream is applied directly inside the vagina using a special applicator supplied with the cream. It should not be taken by mouth. Estradiol vaginal cream is available only with a doctors prescription. It is important to follow the directions on the prescription label and read the package directions carefully before using the cream. The cream should be used initially nightly for one month, and then as directed by the doctor. Estradiol vaginal cream is indicated in the treatment of moderate to severe symptoms of vulvar and vaginal atrophy due to menopause. It should not be used to prevent heart disease or dementia. Estrogens can increase the risk of cancer of the uterus (endometrial cancer), so taking a progestin as directed by the doctor can help decrease this risk. Women who have not had a hysterectomy should be given another medication called a progestin to take with topical estradiol.