There are many estrogen products and they can be used in very small doses to give women good results. Estriol the weakest estrogen is widely used in Europe to treat women with vaginal dryness and urinary incontinence due to perimenopause and menopause. In the United States we tend not to prescribe this form of estrogen. But it is available by prescription through a compounding pharmacy. This is a good example of a way to treat a woman through good estrogen management by pinpointing the right estrogen for the right symptom.
Many folks think estradiol is the best estrogen because it's the one that is made by our ovaries.
But the problem is while it may severely decrease hotflashes it does very little for vaginal dryness and urinary incontinence. Not all estrogens do the same job in the same way. For women with breast cancer with hotflashes, taking estrogen is not an acceptable form of therapy, because it can make the cancer worse. Loprinzi has found Effexor to be the best non-hormonal therapy for women with hot flashes and breast cancer. Not only did the participants in the study have less flashes, but they also had a better sense of well-being and sleep better.