My VA was/is so bad I use vagifem 5 xs a week and systemic HRT also . I have not had one hot flush my menopause is also urogenital atrophy.
I am under one of the very top experts for hormones , and he says VA can cause real problems for everything down there and the only treatment is oestrogen.
Some of you have some real dinosaurs of GPs who are telling you absolute rubbish re local oestrogen. I suggest you arm yourselves with the latest NICE guidelines and read up and educate yourselves and GPs. I think a lot of it is money to be honest.
I would look at the long term effects of many drugs that are handed out like sweets, drinking alcohol , smoking , over weight , lack of exercise etc put you at greater risk of BC.
The more you age , do not underestimate how bad VA can get . VA can not be cured only managed. I have educated my three daughters on VA and they will use oestrogen when / if the need arises.
Re the lady with the thickened womb from a tiny dose of local HRT , I would imagine that was not caused by the local HRT but by the fact that it can and dose just happen, I would have stayed on the local HRT and had a yearly scan and if necessary the odd course of progesterone to shed any build up.