The vaginal estrogen cream comes in a tube with a screw cap and includes an applicator for ease-of-use. To apply the cream, screw the applicator to the top of the tube and squeeze the appropriate dosage into the applicator. Insert the applicator into the vaginal opening, then push the plunger to deliver the cream into the vaginal canal. For optimal effectiveness, the cream needs to maintain maximum contact with the vaginal mucosa, allowing the estradiol to be absorbed into the tissues.

The best time to apply the cream is right before bed. Lying horizontally helps the medication stay in contact with the vaginal walls longer, enhancing absorption. If you plan to have intercourse, wait until after sexual activity to apply the cream.

Some of the cream may naturally exit the vaginal canal the next morning when you're upright and moving around. To manage this, consider wearing a panty liner or underwear you don’t mind changing. After each use, rinse the applicator thoroughly with mild soap and water to remove any remaining vaginal secretions. A cotton swab (Q-tip) can help ensure the applicator is fully cleaned.