It takes time for the tissues to respond, hence the 2 week loading. Once your tissues are ok, then it is much more stable and you learn the early signs of when it isn't working and you need a bit more. You might find that the 2x weekly is not quite good enough. I use mine (vagifem) every 3rd day but went though a phase of not managing so using it every other day (prescription said 1 or 2 twice a week, so was happy that was within what I was told) As time goes on, it gets more stable.
I expect you may have uti-like problems until it settles. I know I did with thrush, which is why I had to get tablets and the Actigel a couple of times.
To start with, it can be a bit up and down.
Not sure I am making any sense here