Hi SGNW, I'm considerably older than you & was already postmenopause when I started vaginal oestrogen so our situations are different, but I do have a long history of migraine with aura, have used the 0.01% Estriol cream for some years without problems & would not want to be without it. Estriol is a very weak form of oestrogen & as your gynae says, used locally this
should not exacerbate migraine tendency. I also had frequent thrush over many years prior to hysterectomy so know the misery of this horrible condition.
I also use Vagifem, which was my first experience of HRT & this contains the stronger oestrogen oestradiol. During the first couple of weeks I did get headaches daily, but not of migraine strength & without aura. They were bearable & petered out with continued use. I believe others have reported the same on here. I mention this just in case you find you do have some initial start-up reaction, but really as Estriol is such a weak form of oestrogen I would hope not. Some migraineurs are very sensitive to triggers though, so I do understand your caution.
Any start-up reaction could be explained by the fact that some oestrogen is said to be absorbed systemically in the initial weeks of topical treatment if the vaginal tissue is in poor condition as often happens as hormonal decline progresses, but once the integrity of the mucosa is restored there is something of a barrier effect keeping the oestrogen local to the GU tract, where it does magical things to keep us comfortable. Do bear in mind though that vaginal oestrogens are very low dose & don't usually give rise to problematic systemic effects.
Estriol cream was added to my HRT regimen after I'd been on Vagifem for some time & I had no adverse reaction to it. I have also been on systemic transdermal HRT for some years without major headaches or aura. I hope this is reassuring.
I'd say try the cream & see how you get on. You're in the driving seat
. I hope you find it helps.
Wx
