Dear Hopeful,
I can't respond specifically to your concerns about the Estring but hope somebody will.
I take two high blood pressure meds that are metabolized through the liver but the benefit outweighs the risk. My hepatologist thinks it's a non-issue. That doesn't mean he has the last word but we made a practical decision . It's not because I'm not his wife that he's 'nonchalant' but that he had to juggle my competing health needs and prioritize them.
Nothing like reading inserts to feel cool, calm and confident about the medications we take. I had to look hard to find the liver warning for estradiol because it's buried among every potential hazard under the sun.
It's tough to know what to do in the face of such dire warnings. Sometimes I admit I ignore them, throw a coin in the fountain and hope it all comes out right.
Talking to your gynecologist might be more instructive about this issue, since estrogen risks are the talk of the town in that speciality field.
What stands out from the Women's Health Network about estradiol (with or without added oral progesterone) is the focus on cancer risk and cardiovascular risk.
Here are some links:
http://www.rxlist.com/estring-drug.htm
http://www.drugs.com/mtm/estring-topical.html
http://www.mdconsult.com/das/yearbook/body/120908982-2/jorg=journal&source=MI&sp=10718048&sid=0/N/167079/1.html (can sign up for thirty days free)
In my view, if you intend to use the Estring temporarily to deal with a seriously bothersome issue that you can't otherwise resolve, then the benefit would outweigh the risk. In your case, you stand a good chance to only need exposure temporarily.
I hope our livers are tough babies and will cope with our extra meds during tx.
In the meantime, I keep doing my kegels in the hope that serves some useful purpose.
Good luck.
I'm sorry I've never heard of it so I can't give you any advice on it...I'm sure someone will come along with a good answer but as always - listen to your doctor above anybody on an internet forum! :)