mine made it worse the first few days. didn’t keep going bc that kind of acute worsening usually means osmolarity irritating already-inflamed tissue, not a time-is-the-answer situation. if systemic estrogen helped yours, the tissue is estrogen-responsive. HA addresses dryness but not the hormone-dependent atrophy piece. different tools for different mechanisms. my T said it plainly: worsening is data. you and your doc probably know what you’re testing for, but the mechanism matters. are you treating pain, or inflammation, or dryness? those shift what actually fits. just wanted you to know teh worsening itself is real feedback.