Compounded HRT · Vaginal
Progesterone + Estradiol Vaginal Cream
A compounded vaginal cream used for provider-supervised relief of vaginal dryness, irritation, and discomfort from menopause.
- Applied vaginally, acts locally
- Targets vaginal dryness and discomfort
- Lower systemic absorption than body-wide HRT
- 3-month supply
$299 total
About $100/mo · 3-month supply
Includes your provider consult and medication, shipped to you.
Provider-reviewed · Cancel anytime
Every plan includes
- Licensed provider review of your intake
- Compounded hormone therapy shipped from a licensed pharmacy when prescribed
- Unlimited messaging with your care team and provider
- Free shipping on every order
- Dose adjustments as your provider directs
What it is and how it works
As estrogen falls in menopause, the vaginal and urinary tissues can become thinner, drier, and more easily irritated. This is called genitourinary syndrome of menopause, and it can cause dryness, itching, discomfort during sex, and urinary symptoms.
This vaginal cream is applied locally, where the hormones act directly on the tissue. Because it is used vaginally rather than across the whole body, systemic absorption is typically lower than with body-wide hormone therapy.
The cream is prepared by a licensed compounding pharmacy. A Josie provider reviews your health history and intake before any prescription is issued, and adjusts your plan over time.
Who it’s for
May be a fit if you
- Have vaginal dryness, irritation, or discomfort during sex
- Have urinary symptoms related to menopause
- Want relief focused on vaginal tissue rather than whole-body symptoms
- Want licensed provider oversight and ongoing support
Not appropriate if you
- Are pregnant, trying to conceive, or breastfeeding
- Have a history of breast cancer or another hormone-dependent cancer
- Have unexplained vaginal bleeding
- Are advised against hormone therapy by your provider
If you also have whole-body symptoms like hot flashes, your provider may discuss a systemic option. Eligibility is always determined by a licensed provider after reviewing your intake.
How to use it
- 1Your provider confirms your dose and schedule, often more frequent at first, then less often for maintenance.
- 2Apply the cream vaginally as directed, usually at bedtime.
- 3Follow your provider’s instructions on the applicator and amount.
- 4Message your care team with any questions or for adjustments.
Safety, risks & side effects
Vaginal estrogen carries lower systemic exposure than body-wide therapy, but hormone therapy still carries risks. Review them with a licensed provider and read the full prescribing information before starting.
Boxed warning: Estrogen products carry a class warning. Estrogen-alone therapy increases the risk of endometrial cancer in women with a uterus, and studies of systemic estrogen have reported increased risks of stroke, blood clots, and, in some women, breast cancer and probable dementia. Vaginal estrogen is used locally at lower doses; your provider will determine what is appropriate and use the lowest effective dose.
Common side effects
- Vaginal irritation or itching
- Vaginal discharge
- Mild burning at application
- Breast tenderness
- Headache
Serious risks
- Endometrial changes with longer-term use
- Blood clots
- Stroke
- Breast cancer
- Allergic reaction
Do not use if you have
- Known, suspected, or history of breast cancer or hormone-dependent cancer
- Unexplained vaginal bleeding
- History of blood clots or stroke
- Pregnancy
How it compares
Frequently asked questions
What is the vaginal cream used for?
It is used for vaginal symptoms of menopause, such as dryness, irritation, discomfort during sex, and some urinary symptoms, together known as genitourinary syndrome of menopause.
How is it different from the body cream?
The vaginal cream is applied locally and works mainly on vaginal and urinary tissue, with lower systemic absorption. The body cream is applied to the skin for whole-body symptoms like hot flashes. Some women use a systemic option and a vaginal option together, as directed by a provider.
Can I use it if I have whole-body symptoms too?
Vaginal estrogen targets local symptoms. If you also have hot flashes or night sweats, your provider may recommend a systemic option in addition to, or instead of, the vaginal cream.
How soon will I notice a difference?
Many women notice improvement in dryness and comfort over a few weeks of regular use. Your provider will set expectations and adjust your plan as needed.
How much does it cost, and is there a membership fee?
The vaginal cream is provided as a 3-month plan. Your plan price includes the provider review, ongoing messaging, and shipping. There is no separate membership fee. Current pricing is shown above.
Is there a consultation fee?
There is no upfront fee to complete your intake. A $80 consultation fee applies only if a licensed provider approves your care plan and you then choose not to proceed with treatment.
Do I need an in-person appointment?
No. Josie is telehealth. You complete an online intake and a licensed provider reviews your health history and goals. If they have questions, your care team follows up by message, so there is no in-person visit required.
Which US states is Josie available in?
Josie is available in all 50 US states.
Is compounded HRT FDA approved?
No. Compounded medications are not FDA approved, and the FDA does not review them for safety, effectiveness, or quality before marketing. FDA-approved hormone therapies also exist. A licensed provider determines whether compounded hormone therapy is appropriate for you.
How do I start?
Complete the online intake. A licensed Josie provider reviews your history and, if appropriate, prescribes your plan, which is shipped from a licensed pharmacy.
Compounded hormone therapy is not FDA approved. The FDA does not review compounded medications for safety, effectiveness, or quality before marketing.
Medications are only issued when clinically appropriate after a provider evaluation. Josie does not manufacture compounded medications, and the actual product appearance may differ from website images.
What to Expect at Josie
- Complete your intake online, from anywhere
- Provider review by Josie's licensed clinicians, supervised by Dr. Ana Lisa Carr, MD
- Transparent program pricing
- Medication shipped from a licensed pharmacy or compounding pharmacy when prescribed