The little-known benefits of vaginal hormone delivery

As I have mentioned, hormone-replacement therapy transforms lives for women from their 40s to their 80s, giving women the ability to build bone and muscle, prevent cancer, and many more benefits. Here, I’ll talk about the benefits of local hormones applied as vaginal creams and rings. Not only do most women not know about these products, but if you’re reading this and you’re a woman, you can probably benefit.

Vaginal creams reduce menopause-related challenges like vaginal dryness, painful intimacy, reduced sexual desire, and life-threatening urinary tract infections (UTIs). Using DHEA (dehydroepiandrosterone), estradiol, or compounded creams, these treatments deliver profound benefits—safe, affordable (thanks to Mark Cuban’s Cost Plus Drugs pharmacy), and life-changing.

A Lifeline Across Decades
In their 40s and 50s, women in perimenopause often face vaginal dryness, discomfort, and reduced sexual desire, even on systemic HRT. Jessica, a 48-year-old teacher, struggled with these issues and recurrent UTIs. A compounded estradiol-testosterone cream from Cost Plus Drugs, costing $15 monthly, eliminated her symptoms in weeks. “No UTIs, and my sex life is vibrant again,” she says, thriving at home and work. DHEA (Intrarosa, 6.5 mg daily) converts locally into estrogens and androgens, boosting lubrication by 115%, reducing pain during intercourse by 108%, and increasing desire, arousal, pleasure, and orgasm by up to 49%, per studies. Estradiol (Vagifem, applied 2–3 times weekly) strengthens vaginal walls. Compounded creams, blending DHEA, estradiol, progesterone, or testosterone, offer tailored relief, with progesterone reducing inflammation and testosterone enhancing libido—crucial for perimenopausal women seeking sexual vitality.

In the 60s and 70s, these therapies restore comfort. Linda, 68, used a $18 DHEA-progesterone cream to end UTIs and painful intimacy. “I’m enjoying romance again,” she says. UTI prevention is critical, as menopause thins vaginal and urinary tissues, increasing infection risk that can escalate to sepsis. Studies show vaginal hormones cut UTI rates by 50%. Marjorie, an 83-year-old ICU patient post-heart surgery, avoided a deadly UTI with daily DHEA cream. “It kept Mom safe,” her daughter said.

At 79, Sarah struggled with vaginal dryness, urinary urgency, and a UTI about once a year. A DHEA-testosterone cream relieved her discomfort, improved bladder control, and restored her confidence. “I used to get a UTI yearly, but I haven’t had one since starting the cream,” she says. “I’m back to enjoying book club and lunches with friends without worry.”

Vaginal Rings: Simple and Effective
Vaginal rings, like Estring, are flexible, silicone devices inserted into the vagina to release low-dose estradiol for 90 days. Women insert them (like a tampon) and replace quarterly, with no daily upkeep. Studies show 80–90% improvement in dryness, discomfort, sexual function (including desire and orgasm), and UTI prevention by supporting urinary tissues, ideal for busy or mobility-limited women.

The labeling problem
The FDA’s labeling for vaginal hormone products, like estradiol creams and rings, often includes warnings about risks like blood clotting, which apply to oral estrogen but not low-dose vaginal therapies. These outdated warnings, rooted in systemic oral-estrogen risks (oral estrogen is no longer used), create confusion, giving doctors, pharmacists, and nurses pause. Many hesitate to prescribe or administer these treatments, unsure of their safety due to mislabeling, which limits patient access to life-changing care. Dr. Rachel Rubin, a urologist, has advocated for change, stating, “The boxed warnings on vaginal estrogen are outdated and misleading; these products are safe with minimal systemic absorption, yet the FDA clings to systemic hormone risks, limiting access to life-changing care” (2023 interview with The Washington Post). Her efforts underscore that vaginal hormones, with negligible systemic effects, don’t carry the same dangers, yet mislabeling persists, hindering proper prescribing and use.

Safe, Affordable, and Impactful
These therapies are safe across decades, with localized action avoiding risks like blood clotting. Trials report only mild side effects like discharge. Mark Cuban’s Cost Plus Drugs offers estradiol cream for $13.21 versus $293.66 through Medicare. Cuban told PBS in 2022, “Our approach at Cost Plus Drugs… show you our actual cost, mark it up 15%, add $3 pharmacy handling fee and $5 shipping… has really had an impact.” Dr. Rachel Rubin, a urologist, states, “Vaginal hormones prevent UTIs by more than half, improve arousal, orgasm, and lubrication, and could save the healthcare system $6 to $22 billion annually by reducing infections and doctor visits.” A tube of vaginal cream used to cost hundreds of dollars, now it’s only $18 plus shipping.

You may not have even heard of this, which shows how misinformation travels. Doctors should be talking with all their patients about adding local delivery of hormones to any woman’s health regime. All women should explore vaginal hormone therapy for its ability to enhance sexual desire, arousal, pleasure, orgasm, protection, and overall quality of life, while preventing costly infections—whether in perimenopause, living vibrantly in her 70s, or in the ICU in her 80s. Consult your healthcare provider to explore FDA-approved Intrarosa, vaginal rings, or compounded creams through Cost Plus Drugs or local pharmacies.

Disclaimer: Consult a healthcare provider before starting treatment.

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