Hi Fiftyplus. You probably do have atrophy as it seems very common. Mine began in about 2008 long before any other menopause symptoms, which didn't start until 2020. I noticed a slightly sore patch high up in my vagina during sex, to begin with. By 2012 ish it had become impossible to have sex and the pain was both the whole of my vagina and all my vulva, clitoris, everywhere and by then was excruciating.
The cream us LMX 4 - 4% lidocaine. Its fantastic but do be warned, the stinging when first applied is bad but in the end the relief if bliss. My gynae was telling me I had vulvadynia and I didn't agree so she said using the cream prior to sex would prove she was right as nerve pain cannot be eased with the cream. In the end I was right. So I apply it a couple of minutes before sex, just cover your finger on it and get it inside, then put some outside wherever you need it. You don't need loads, just experiment until you get the right amount of pain relief. I get hubby to put some on his you know what too (tee hee) because it makes sure you'll get some high up in your vagina. For us, it means we can still have a sex life which is great. Just search for it online.
With regards to any other time, perhaps just a little externally if you get pain wearing clothes etc or if you're having a bad day. Other than that, save it for just sex and the odd few hours of relief. Hope it helps you.