I agree that vaginal estrogen doesn’t seem to care the same risks as oral estrogen. This is what the Mayo Clinic said about vaginal estrogen. When there are that many cautions, and coconut oil will work, just saying. I would rather stick with coconut oil and not worry about it.

“It is not yet known whether the use of vaginal estrogens increases the risk of breast cancer in women. It is very important that you check your breasts on a regular basis for any unusual lumps or discharge. Report any problems to your doctor. You should also have a mammogram (x-ray picture of the breasts) done if your doctor recommends it.

It is important that you have a regular pelvic exam (pap smear). Your doctor will tell you how often this exam should be done.

Talk to your doctor if you have high blood pressure, high cholesterol (fats in the blood), or diabetes, use tobacco, or are overweight. You may have a higher risk for getting heart disease.

Although the chance is low, use of estrogen may increase your chance of getting cancer of the ovary or uterus (womb). Regular visits to your health professional can help identify these serious side effects early.

If you think that you may be pregnant, stop using the medicine immediately and check with your doctor.“

This is correct. I first learned that I had a problem when I had terrible’UTI’ pain. The urology clinic sent me to a uro-gynecologist. This was years ago and I still see her. She diagnosed me with pelvic floor collapse and put me on the estrogen cream. She also sent me to pelvic floor PT. This worked and I keep it up. She and the PT explained that when the vaginal walls thin out, so do the tissues of the urinary track. Thus, pain as with a UTI.