Suzysunday - please don't worry about the Ovestin cream - I've used that too in the past, but just don't get on well with internally applied creams of any sort, so the Vagifem suits me better. Just insert the Ovestin with the applicator as the info leaflet advises & at the frequency agreed with your doctor. The cream is meant to coat the internal area & will disperse as it should to work its magic & keep you healthy & comfortable down there. The form of oestrogen it contains is weaker than that in Vagifem. With Vagifem it is a tiny pessary without a cream base, so more concentrated than the Ovestin & it seems there is a more localised effect with it, which is why some of us find varying insertion depth can improve our symptoms.
I had intermittent pmb for the whole time I was on conti HRT (postmenopause) & had the various necessary investigations, so I do understand that can be a worry, but topical HRT is far weaker & therefore very unlikely to cause you problems of that nature.