Hiya, I can only tell what its like for me and we are all different. I use the cream when I feel outer dryness or soreness, can be 2 or 3 times a week. I don't really notice any other symptoms on the whole, this regime works for me. If I feel the signs of VA returning is when I will do a reload. Don't worry about too much vagifem as the 10mcg can be used every night if need be as it is topical and very little, if any, is absorbed into your system.
I just judge by how it is all feeling but may I say try not to overthink it all too much. If you feel you need a bit extra help then use a bit extra, you won't hurt yourself. It isn't an exact science.
Please remember this is my own experience, another member may say something different. You need to decide what works for you at the end of the day.
Good luck.