I use vagifem every other night , and the other nights I use ovestin in the vestibule on my episiotomy scars.
So 7 days a week there is a form of local oestrogen going onto or into my bits , I also use Gyn-actigel every am/ PM.
I am also on systemic HRT all for the VA , my vulva area is unrecognisable from what it looked like two years ago , episiotomys almost tearing , swollen urethra , labia minors like tissue paper so so thin , clitoral hood right back exposing the gland 😳.
Even my anal fissure has as good as healed , my itchy scaly legs / body are as soft as babies skin again , the list goes on mouth / nose and ears all the mucosal membranes.
I have given up worrying about the amount of HRT required for my nether regions , and live in the now as no one knows what tomorrow will bring.
My GP is absolutely fine with this and said VA is hers and the other lady GPs " bread and butter" .