MD Anderson does not recommend topical Estradiol cream if someone has had ER+ cancer. They will not prescribe it. My Baylor Scott & White PCP also will not prescribe topical cream but will write a prescription for the vaginally inserted tablets. I believe the research that says little is absorbed systematically is based on the inserted tablet.
I have not found the tablet to be very helpful to me. It may increase moisture inside, but does little to nothing in the outer area that gets a lot of friction.