Hello Witchinghour
I began HRT when I was three years post meno and my VA symptoms were mild. Intercourse was painful and I needed to use the bathroom during the night but other than that I was okay.
A few years ago I came off all HRT and two weeks after my last, low dose of Oestrogen my symptoms ramped up considerably. I experienced the pain, burning and itching that other ladies talk about and I began to notice my episiotomy scar from over thirty years ago lol. For other reasons I resumed HRT and within two weeks the VA started to settle and return to previous levels.
Just recently I was reducing Oestrogen again and at a very low dose the dryness became more noticeable. I increased my gel a little and, once more within two weeks the VA felt much better.
From all of this I have concluded that zero or very low levels of Oestrogen lead to increasing symptoms of VA but slightly higher amounts of Oestrogen resolve these symptoms after two weeks.
I hope that is helpful to you.
Take care.
K.