linfit - it does sound typical of the sort of expensive gimmicky thing that is produced in US because of their different healthcare system.
![Roll Eyes ::)](https://www.menopausematters.co.uk/forum/Smileys/extended/rolleyes.gif)
In fact that cream contains DHEA which is a precursor hormone to oestrogen and testosterone. This is actually approved by FDA in US as a treatment for GSM (or VVA!) - as vaginal capsules "Intrarosa" - which, if you're in US, should be available from your regular doc - whoever you see. They are not approved here in UK yet. I can't download the actual paper about the trials but as reported the DHEA is converted to oestrogen locally in the cells and after 12 weeks the systemic levels of oestrogen are maintained within post-menopausal levels. However this is also true of vagifem and the other creams.
It (Intrarosa) has received recommendation from the European Medicines Agency (EMA) so I imagine we are likely to see it being available here sometime in the near future ( (I don't know how long these things take...)
I would get hold of the currently available moisturisers (of which there are many) in conjuction with either Vagfiem and an estriol cream. In UK we have generic estriol cream at a concentration of 0.01% as well as Ovestin (which is 10 times stronger at 0.1%) which maybe more suitable for rubbing in more liberally over external parts. I am sure there must be similar in US.
There are unlikely to be any side effects unless you are allergic to any of the fillers. Estriol is a very weak oestrogen but works well in the vaginal area as it binds preferentially to a particular oestrogen receptor found in this region of the body.
Hurdity x