I think its actually classed as the weaker of the estrogens but i think it does the job better on the outside bits. I use it inside too sometimes. Theres not just one remedy for VA im afraid, its a combination of lots of things, like washing just in water or using Cetraben, i dont wash my pants in soap powder, just a 60° wash then tunble dry as detergent will set me off. Sitting for long periods of time, not drinking enough and getting dehydrated will leave me dry and sore. YES waterbase helps sometimes but if im sore everything stings and irritates. Dermavate is soothing and since having this added to my regime i have got a lot better, which makes me think the vulva clinic were right and its not just VA but Lichens aswell. I've been ok for a while now but then sometimes get complacent and take less meds but it always comes back to remind me, so always keep up the treatment even when you do start to improve, it just takes a while . Ive had this now for 5 years and in the first year i never thought it would improve, id be ok one week then bad again the next and confused what id done different, usually nothing. Use everything youve been given and ask for more if its not enough, id use the Vagifem a.m and the cream at night and put a little inside too, you'll get there.