Local Vaginal Estrogen Therapy
We offer prescription local hormone therapy to support vaginal tissue health, comfort, and sexual wellness. Options include standard vaginal estrogen 0.1% cream as well as customized compounded formulations containing estriol and DHEA. These therapies work locally to improve tissue elasticity, hydration, and blood flow while minimizing systemic absorption. Treatment is individualized based on your symptoms, medical history, and hormone goals to safely address concerns such as dryness, irritation, discomfort with intimacy, and genitourinary symptoms of menopause.
Online Medical Evaluation
This treatment is available through a secure message-based consultation. You’ll complete a detailed health questionnaire and communicate directly with your clinician through our encrypted portal. If medically appropriate, a personalized prescription will be sent to your selected pharmacy.
This approach offers convenient, private care without requiring a live appointment.
Estradiol Vaginal Cream (0.01%)
Estradiol Vaginal Cream (0.01%) 30g tube Rx with 3 refills.
Evidence-based treatment for genitourinary syndrome of menopause (GSM) which includes vaginal dryness, burning/irritation, painful sex, recurrent UTI's, urinary urgency/frequency, vulvar dyscomfort related to perimenopause/ menopause. Simple online intake with clinician review and annual prescription if appropriate.
👉Insurance Range: vary but range 10-100/month with most plans on the lower range.
👉Cost Plus Pharmacy (cash-pay, no insurance accepted, mail order) $13.21/month.
Estriolol/DHEA 0.5mg/5mg/ml Vaginal Cream 30grams
Estriolol/DHEA 0.5mg/5mg/ml Vaginal Cream 30grams. Rx is provided with 3 refills.
Why estriol + DHEA?
How Estriol and DHEA Work Together
Estriol
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Estriol is the weakest naturally occurring estrogen
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It primarily acts locally on vaginal tissue
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It supports tissue thickness, elasticity, and moisture
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It is generally associated with less systemic estrogen activity compared to estradiol
DHEA (Dehydroepiandrosterone)
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DHEA is a hormone precursor naturally produced by the body
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When applied vaginally, it can be locally converted within vaginal tissue into small amounts of estrogen and androgens
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This supports tissue health, sensation, and comfort without acting as systemic hormone therapy
Together, estriol and DHEA provide local hormonal support at the tissue level, rather than delivering a stronger systemic estrogen signal.
Why Some Patients Choose Estriol/DHEA Instead of Estradiol Alone
Estradiol vaginal therapy is very effective and remains a standard treatment for GSM. However, some patients prefer estriol/DHEA because:
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Estriol is less potent than estradiol and may feel gentler for long-term local use
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The combination supports vaginal tissue through multiple pathways, not estrogen alone
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Some patients experience better comfort or sensation with DHEA-containing products
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It may be preferred by patients who are sensitive to estradiol or want a lower-potency option
This option is not necessarily “better” than estradiol, but it can be a better fit for certain patients.
Important Expectations
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Estriol/DHEA vaginal cream is local therapy, not systemic hormone replacement
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It is not intended to treat hot flashes, night sweats, or other whole-body menopausal symptoms
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Improvement is typically gradual, occurring over several weeks
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Results vary, and some patients may respond better to estradiol alone
How Long Does One Tube Last?
Loading Phase
Dose: 0.5–1 mL nightly
Duration: 2–4 weeks
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0.5 mL nightly
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30 g ÷ 0.5 mL = ~60 doses
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Lasts ~8–9 weeks if used nightly
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1 mL nightly
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30 g ÷ 1 mL = ~30 doses
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Lasts ~4–5 weeks if used nightly
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At maintenance dosing:
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0.5 mL, 2–3×/week → tube can last 3–4 months
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1 mL, 2–3×/week → tube can last 6–8 weeks