Dr. Uzzi Reiss shared the nuances of vaginal application for hormones at the Women’s Hormone Network, Irvine, California, November 2019 He explained that the vagina actually has 4 different blood supplies.
If you use an applicator and apply a hormone cream deep into the vagina, the absorption of hormones in that area is systemic, affecting the entire body. If the hormones are delivered to the middle area of the vagina, the circulation takes the hormones to the uterus.
To actually treat dry and atrophied vaginal tissue, the hormones should be applied to the first two inches of the vagina.
When hormones are applied to the opening of the vagina, the blood stream again will carry hormones throughout the entire body.