Local care for menopause vaginal symptoms
Vaginal estradiol is an FDA-approved estrogen placed in the vagina, as a cream or a small insert, to treat moderate to severe vaginal dryness, irritation and related symptoms after menopause. It is prescribed online only if a licensed provider decides it is right for you after reviewing your health history.
Coming soon to Forever Health Rx. Not available for purchase yet. Prices shown are estimates and may change.
Notify me when availablePrescription only. A licensed provider decides.
Vaginal estradiol is an FDA-approved estrogen cream or insert placed in the vagina; if a licensed provider prescribes it, it may help with:
Approved to treat moderate to severe vaginal dryness, burning and irritation due to menopause.
Works by placing a small amount of estradiol directly in the vaginal tissue that thins after menopause.
For vaginal use only; it is not approved to treat hot flashes or other body-wide symptoms of menopause.
Your provider decides which form and dose fit you after reviewing your health history.
Follow-up and questions go through the patient portal, and a licensed pharmacy ships what is prescribed.
Not medical advice. Individual results vary. A licensed provider decides whether a treatment is right for you.
Estradiol vaginal cream is FDA-approved to treat moderate to severe symptoms of vulvar and vaginal atrophy due to menopause. Estradiol vaginal inserts are FDA-approved to treat atrophic vaginitis due to menopause. Both terms describe the thinning, dryness and irritation of vaginal and vulvar tissue that can follow the drop in estrogen at menopause. These products are for vaginal use only and are not approved to treat hot flashes or other systemic symptoms of menopause.
Estradiol is a form of estrogen. After menopause, lower estrogen levels can make the lining of the vagina thinner and drier, which some people feel as dryness, burning, itching, soreness or discomfort. Placing a small amount of estradiol directly in the vagina may help restore that tissue for some people; results vary. The cream is placed with a calibrated applicator; the insert is a small tablet placed with a single-use applicator that dissolves over a few hours. The labels state that some estradiol is absorbed into the bloodstream from vaginal use, so the warnings that apply to estrogen as a class also apply here. Your provider decides which form and dose fit you.
A provider may consider vaginal estradiol for adults with moderate to severe vaginal symptoms of menopause after reviewing personal and family history. It is not for people with unexplained vaginal bleeding, current or past breast cancer or another estrogen-dependent cancer, current or past blood clots, a stroke or heart attack, liver disease, a known clotting disorder, a known or suspected pregnancy, or an allergy to the product. Your provider decides.
Answer questions about your health history, medications and goals. Submitting a visit does not guarantee a prescription.
A provider licensed in your state decides whether treatment is appropriate for you, or recommends a different path.
A licensed pharmacy dispenses your medication and ships it to your door. Follow-up continues through the patient portal.
The cream is approved for moderate to severe symptoms of vulvar and vaginal atrophy due to menopause, and the inserts for atrophic vaginitis due to menopause. In everyday terms these are the dryness, burning, itching, soreness and discomfort that can come from thinning vaginal tissue after menopause; many clinicians now group them under the term genitourinary syndrome of menopause. A licensed provider reviews your symptoms and history to decide whether treatment is appropriate.
No. Vaginal estradiol is a local product approved for vaginal symptoms only; it is not approved to treat hot flashes. Even so, the labels state that some estradiol is absorbed into the bloodstream, so the warnings and precautions written for oral estrogen are to be taken into account, and the products carry the same boxed warning as other estrogens. If you also have hot flashes or other symptoms, your provider can discuss whether a different form of estrogen fits you better.
A boxed warning is the FDA's most prominent safety warning. The current vaginal estradiol labels carry the estrogen class warning about endometrial cancer with estrogen alone, and the stroke, blood clot, heart attack, breast cancer and probable dementia findings of the Women's Health Initiative studies. In November 2025 the FDA asked makers of local vaginal estrogen products to condense their safety information and to remove this language from the boxed warning; labels are being updated product by product, and this page follows the current cream and insert labels.
Estrogen taken alone raises the risk of endometrial cancer in a woman with a uterus, and estrogen labels say a progestogen is generally added to reduce it. The insert label includes a warning section about adding a progestogen when a woman has not had a hysterectomy. Whether that applies with a vaginal product is a decision for your provider, who will also ask you to report any unusual vaginal bleeding right away so it can be evaluated.
Vaginal dryness and irritation can make sex uncomfortable or painful, and these products are approved to treat the tissue changes behind those symptoms. They are not approved to increase desire or sexual performance, and how much they help varies from person to person. If low desire or pain with sex is part of what you are experiencing, tell your provider so they can look at the whole picture with you, respectfully and without pressure.
The cream is measured with the calibrated applicator that comes with it and placed in the vagina; the applicator is washed afterwards with mild soap and warm water, never boiled. The insert comes in a single-use applicator that you gently insert and press to release the tablet, then discard. Use exactly as your provider and your pharmacy label direct, and do not share the product with anyone else, even if they have the same symptoms.
You complete a health assessment online and a licensed provider reviews your answers and history. If they decide vaginal estradiol is appropriate, a licensed pharmacy dispenses it. Forever Health Rx is a telemedicine platform, not a pharmacy, and completing an assessment or paying does not mean you will receive a prescription. Not everyone qualifies, and individual results vary.
Estrogen taken alone increases the risk of endometrial (uterine) cancer in a woman with a uterus. Any undiagnosed, persistent or recurring abnormal vaginal bleeding should be evaluated, including endometrial sampling when indicated, to rule out cancer. Estrogen, with or without a progestogen, should not be used to prevent heart disease or dementia. The Women's Health Initiative (WHI) estrogen-alone study reported increased risks of stroke and deep vein thrombosis in postmenopausal women taking oral conjugated estrogens alone, and the estrogen-plus-progestin study reported increased risks of blood clots in the lungs, deep vein thrombosis, stroke, heart attack and invasive breast cancer. The WHI Memory Study reported an increased risk of probable dementia in postmenopausal women 65 or older. The labels state that systemic absorption may occur with vaginal estradiol and that the warnings, precautions and adverse reactions of oral estrogen should be taken into account. The current labels advise prescribing estrogen at the lowest effective dose and for the shortest duration consistent with treatment goals and risks for each woman.
Estradiol vaginal cream is FDA-approved to treat moderate to severe symptoms of vulvar and vaginal atrophy due to menopause. Estradiol vaginal inserts are FDA-approved to treat atrophic vaginitis due to menopause. Both terms describe the thinning, dryness and irritation of vaginal and vulvar tissue that can follow the drop in estrogen at menopause. These products are for vaginal use only and are not approved to treat hot flashes or other systemic symptoms of menopause.
Common side effects: vaginal burning, irritation or itching after insertion, vaginal yeast infection, irregular vaginal bleeding or spotting, headache, breast pain, abdominal cramps or bloating, nausea, hair loss, fluid retention, back pain and diarrhea. These are not all the possible side effects.
You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Vaginal estradiol should not be used during pregnancy; known or suspected pregnancy is listed as a contraindication on the cream label. Estrogen can pass into breast milk, so tell your provider if you are breastfeeding.
For vaginal use only. Do not give this medicine to other people, even if they have the same symptoms.
Prescription only. Vaginal Estradiol is available only after an online visit with a licensed provider, who determines whether treatment is appropriate for you. This summary does not replace the full prescribing information. Not medical advice. Results may vary.
Forever Health Rx does not provide emergency medical care. Call 911 or go to the nearest emergency department if you are experiencing a medical emergency. For urgent questions about a serious side effect, message your care team through the patient portal and seek in-person care if symptoms are severe.
Vaginal Estradiol is coming soon to Forever Health Rx. Contact us and we will let you know when it is available.
Have a question before you start? Call our support team:
Prescription required. Eligibility is determined by a licensed provider. Not medical advice. Results may vary.
