Hi! Vaginal atrophy treatment should be used on a continual basis for ever. Initially it's for 2-3 weeks nightly, followed by as necessary: recommended is every 3/4th and 5/6th night. Some require it nightly as well as a moisturiser or 'ovestin' for the labia to stop the skin thinning = itching.
What are your periods doing? Mine waxed and waned for several years B4 stopping, which is when peri-menopause symtoms might start. As oestrogen levels drop the body may become dry: inside and out; skin, scalp, deep in the ears, nostrils, vagina as well as muscles may become lax = aches and pains.
Some find that keeping a mood/food/symptom diary of use. Browse round. Make notes ;-)