Again, I had been taught that removing the area surgically was the accepted solution to the problem. It is common gynecologic practice to prepare vaginal tissues for surgery with topical estrogen cream.
Estrogen tends to thicken or toughen up the skin, and provide it with a greater blood supply.
Thus, the surgeon not only has better tissue to work with, but post-surgery healing potential is increased. Since vestibular tissue is thin after it has been lasered, I thought it reasonable to prepare it for surgery with a course of topical estrogen. Prior to surgery, several of the women told me they were feeling much better after using estrogen cream, and asked if they could delay the operation. From that small start, I tried topical estrogen therapy with vulvar vestibulitis patients who had never had laser treatment, and found the same positive results. For the vast majority of medical practitioners, just to learn that the vulvar vestibule not be removed surgically is big news.