Bioidentical vaginal estriol/estradiol may be compounded with any additive or lack of any additive.
This is one reason why so many women lean towards a compounded hormone.
Or...
Women can also use hyaluronic acid suppositores which boost moisturizing and then add a systemic estrogen topically to back up the hyaluronic. The systemic estrogen is absorbed and used vaginally. Hyaluronic is also good for the bladder and used in bladder installations for IC/BPS.