5th May 2024

A 60-year-old woman presents with a 6-month history of vaginal dryness, irritation, and dyspareunia.

A 60-year-old woman presents with a 6-month history of vaginal dryness, irritation, and dyspareunia. She is postmenopausal and has no significant past medical history. Her last pap smear was normal. On examination, she has thin and pale vaginal mucosa.

What is the most appropriate first-line treatment?