Re spotting - I have spotted (sometimes bled) about a week after every estrogen increase. So, a week after starting HRT and then a week every time I've gone up. And each time it's lasted a week.
Re estradiol cream - this is really really good at treating local symptoms so it's worth trying to figure out. I recommend asking for some Vagifem pessaries instead, it's much less messy than putting all that cream up there. They come in a preloaded applicator and it's a little tablet which you eject into you(!). It's every day for 2 weeks for the loading dose and then usually twice a week after that, but some women need it more. Not at all messy and doesn't sting. (Some people find the estriol/Ovestin cream stings a bit.) Give your GP a call and just request the prescription change. IF you have external symptoms you can just use the cream you have on the vulva instead of squirting it inside you - that is much less messy as it's less cream....!
