Introduction The improvement in cancer treatment facility in the recent decade has improved survival outcomes for cancer cervix. Significant increase in age specific incidence of cancer in women of 25-50 years age was reported in 2022 national cancer registry program in India. Late radiation effect causing vaginal stenosis is common and affects the quality of life of young patients and vaginal examination during follow-up. Vaginal estrogen therapy has very low systemic effects and is considered safe and effective method. Despite this, it is infrequently prescribed with nothing specified in practice guidelines.

Methods To study acceptability and effects of local vaginal estrogen application on patients of carcinoma cervix any stage, treated by surgery and or radiation, 25 women from age group of 30-50, applied topical estrogen at 0.5 mg once daily, intravaginal and periurethral for 3 months, alternate days for another 3 months until one year. Quality of life assessed by EORTC QLQ-CX24 at 3months and 6 months of follow-up

Results Fifteen patients completed 1 year follow-up; 4 patients completed 6 months follow-up. Ten among fifteen patients continued recommended treatment for 6 months, 2 among 6 patients continued for 3 months. Ten patients answered the quality-of-life questionnaire. Adequate pelvic examination with least stenosis was observed after adequate application for minimum 3 months. Three out of 19 patients had urethral symptoms despite therapy

Conclusion/Implications Vaginal estrogen therapy is acceptable and regular use for at least 3 months is effective in preventing vaginal synechiae and improving quality of life in radiation treated patients