You can use it everyday. The silly leaflet that comes with any localised oestrogen is useless. If somebody has severe VA then using it twice a week is unlikely to be enough. I use Ovestin cream daily. If I miss one day then my VA flares. I have to use it every day.
If I were you I would just use it daily. Once your symptoms are under control you can reduce it if you wish to.
Just to let you know, you can also apply a bit of the cream to the outer area as well as inserting it. I mix a pea size amount with Yes VM and apply to the outer area that way.
