I'm on testosterone and my provider (a nurse practitioner) recommended Estring or a vaginal estrogen cream to prevent vaginal atrophy and/or tearing. However, she also cautioned using estrogen alone can increase cancer risks.

It was also recommended I stay on birth control, but can't take the pill anymore. Neuvaring has both the estrogen to take care of the vaginal atrophy and the progesterone to make it effective birth control as well, and it supposedly stays local in my body and won't affect my testosterone levels. However, my provider seems averse to prescribe anything with progesterone. She won't even give it to my MtF spouse, who has used it before liked it.

Are there any FtMs here who use Neuvaring? Is there any reason I shouldn't ask for it instead of Estring?

And why is my provider so freaked out about progesterone? She acts like it's the end of the world, for both of us!

The progesterone battle has been going on from sometime around the early 1980's. Studies done back then indicated that progesterone had several risks associated with it but the problem is the studies were done with Provera which is a progesterone look alike. Even with bio identical progesterone, the doctors are unsure of the benefits and risks associated with the hormone. Shop around for doctors and you will find just about any opinion you want on progesterone.

In your case, I suspect there will be little risk of cancer from estrogen. Some of what you use will migrate into the body but T will shut down your own production and you are applying will leave your levels far lower than they were before you started T. The one exception to this might be your cervix so it's important you continue to get regular exams.

In studies, so far, bio-identical progesterone has been shown to be relatively safe and we have quite a large sample to extract findings from which are quite reassuring: ciswomen who for ten of thousands of years have been producing VERY high levels of progesterone during pregnancy and who've survived it, again and again, despite having a significant number of children. There is a significant difference between progesterone and medroxyprogesterone acetate and other progestins in birth control pills. These differences have been thoroughly investigated in many studies in the last 15 years or so. Progesterone does not appear to increase the risk of breast cancer, has no effect on coagulation, can improve mood and much less commonly, deteriorate mood, does not oppose estradiol's effects on lipids, can reduce blood pressure and have a positive outcome on vasodilation. It's critical to differentiate between what the human body naturally produces and the other progestogens modified by man. You change the molecule even slightly and will get different effects on the body.