Yes, a lack of estrogen, commonly occurring during menopause, breastfeeding, or following cancer treatments, can cause redness on the labia majora. Low estrogen causes vulvovaginal atrophy, making tissues thinner, drier, and more prone to irritation, inflammation, burning, and redness. This condition is often part of the genitourinary syndrome of menopause (GSM).
Yes, a lack of estrogen, commonly occurring during menopause, breastfeeding, or following cancer treatments, can cause redness on the labia majora. Low estrogen causes vulvovaginal atrophy, making tissues thinner, drier, and more prone to irritation, inflammation, burning, and redness. This condition is often part of the genitourinary syndrome of menopause (GSM).
@kathleen1314 Thank you very much. I am four months post-total hysterectomy. For a few weeks, Imvexxy + compounded Estradiol cream were sufficient, just as it was pre-hysterectomy. Then two months ago I tried Intrarosa for five weeks. I had a honeymoon period of three weeks with it: my libido mostly returned and I wasn't dry. Then I became irritable, hungry at 2am then my labia majora and minora turned red as did the entrance to my vagina. I tried rubbing on DHEA cream externally but it irritated my skin even more. I'm pretty sure I tried Imvexxy again but I was too far gone with a glowing red crotch. Shortly thereafter, I had a minor operation requiring Fluconzaole and an antibiotic. I ended up at my gyn's office. My irritated, thin skin developed a yeast infection. I'm six days into Terconazole along with topical Clotrimazole+Betamethasone. I gave in and inserted a Vagifem this afternoon thinking I was done with Terconazole but I realized I only have one night left so I think it'll be ok. My bladder is so sore without estrogen.
After all of this is done, I'm going to try Vagifem for as long as my delicate skin could possibly gain something from it then try going back to Imvexxy and using a limited amount of Estradiol cream externally.
I was told about the Estring. Are you familiar with it?
Sorry for the long post, but the GSM has been hell.
@kathleen1314 Thank you very much. I am four months post-total hysterectomy. For a few weeks, Imvexxy + compounded Estradiol cream were sufficient, just as it was pre-hysterectomy. Then two months ago I tried Intrarosa for five weeks. I had a honeymoon period of three weeks with it: my libido mostly returned and I wasn't dry. Then I became irritable, hungry at 2am then my labia majora and minora turned red as did the entrance to my vagina. I tried rubbing on DHEA cream externally but it irritated my skin even more. I'm pretty sure I tried Imvexxy again but I was too far gone with a glowing red crotch. Shortly thereafter, I had a minor operation requiring Fluconzaole and an antibiotic. I ended up at my gyn's office. My irritated, thin skin developed a yeast infection. I'm six days into Terconazole along with topical Clotrimazole+Betamethasone. I gave in and inserted a Vagifem this afternoon thinking I was done with Terconazole but I realized I only have one night left so I think it'll be ok. My bladder is so sore without estrogen.
After all of this is done, I'm going to try Vagifem for as long as my delicate skin could possibly gain something from it then try going back to Imvexxy and using a limited amount of Estradiol cream externally.
I was told about the Estring. Are you familiar with it?
Sorry for the long post, but the GSM has been hell.
@blueskies1530
Ok, Intrarosa may be the problem. Ai google lists the inflammation and redness as a know side effect of Intrarosa. Intrarosa is a non bioidentical high powered dhea.
Ai google explanation: "Intrarosa (prasterone) can cause vaginal and vulvar irritation, which may manifest as a red, inflamed, or burning sensation in the labia majora. "
I tried Intrarosa once on my urologist's suggestion. I even cut it into thirds. My testosterone shot off the chart.
My hormone dr was not pleased; he said that intrarosa is not bioidentical, so more dangerous, and it is an extremely high dose of DHEA and that was causing my problems. Lukily I only took a full dose or less due to cutting it into pieces.
You had a much larger dose.
Rubbing more dhea probably made the situation worse; I am sorry.
I still have my uterus and ovaries and until just recently my body produced estradiol and testosterone at good levels. So I just use topically estriol, progesterone and a tiny amount of testosterone plus Estriol vaginally. I am finding that those of us with and without a uterus need different interventions. For some reason the act of surgery to take the uterus/ovaries seems to also impact any organ making enough hormones, whereas my body until recently in my early 70s was making plenty of estradiol and testosterone. That has now changed. Sigh
What I would suggest is to find a hormone specialist who uses BHRT and hormone testing to check your levels. Progesterone is needed for everyone even if they don't have a uterus or ovaries; you need it for systemic health and your breasts. Progesterone also helps with sleep and with those anxiety menopause problems.
You can find a hormone dr specialist by calling your local compounder and asking for someone who uses BHRT and hormone testing.
Or you can use the ZRT website to search for providers that use ZRT testing, some will be doctors, some will be compounders. https://myzrt.zrtlab.com/tools/findprovider
I believe that vagifem is bioidentical, but I have never used it.
Also, copilot can look at all the research and studies and give you some good pointers; you might ask it.
One more cautionary tale, DHEA pulls some major body levers. Some women can take DHEA and pregnenolone and that is their entire HRT. I am so jealous. My body hits those levers hard and huge jumps in everything happens and anxiety goes off the wall. So be very very careful with dhea and pregnenolone.
BHRT is easier to control and maintain plus much safer if used as topical, vaginal. Oral can be dangerous because of liver first pass problems even if it is BHRT.
Lots of hard fought information; I hope some of this is helpful. Find that BHRT hormone doctor who uses hormone testing, especially saliva tests. Everything will fall into place then.
Please let me know how you do with all of this. I will be thinking and concerned about you.
@blueskies1530
Ok, Intrarosa may be the problem. Ai google lists the inflammation and redness as a know side effect of Intrarosa. Intrarosa is a non bioidentical high powered dhea.
Ai google explanation: "Intrarosa (prasterone) can cause vaginal and vulvar irritation, which may manifest as a red, inflamed, or burning sensation in the labia majora. "
I tried Intrarosa once on my urologist's suggestion. I even cut it into thirds. My testosterone shot off the chart.
My hormone dr was not pleased; he said that intrarosa is not bioidentical, so more dangerous, and it is an extremely high dose of DHEA and that was causing my problems. Lukily I only took a full dose or less due to cutting it into pieces.
You had a much larger dose.
Rubbing more dhea probably made the situation worse; I am sorry.
I still have my uterus and ovaries and until just recently my body produced estradiol and testosterone at good levels. So I just use topically estriol, progesterone and a tiny amount of testosterone plus Estriol vaginally. I am finding that those of us with and without a uterus need different interventions. For some reason the act of surgery to take the uterus/ovaries seems to also impact any organ making enough hormones, whereas my body until recently in my early 70s was making plenty of estradiol and testosterone. That has now changed. Sigh
What I would suggest is to find a hormone specialist who uses BHRT and hormone testing to check your levels. Progesterone is needed for everyone even if they don't have a uterus or ovaries; you need it for systemic health and your breasts. Progesterone also helps with sleep and with those anxiety menopause problems.
You can find a hormone dr specialist by calling your local compounder and asking for someone who uses BHRT and hormone testing.
Or you can use the ZRT website to search for providers that use ZRT testing, some will be doctors, some will be compounders. https://myzrt.zrtlab.com/tools/findprovider
I believe that vagifem is bioidentical, but I have never used it.
Also, copilot can look at all the research and studies and give you some good pointers; you might ask it.
One more cautionary tale, DHEA pulls some major body levers. Some women can take DHEA and pregnenolone and that is their entire HRT. I am so jealous. My body hits those levers hard and huge jumps in everything happens and anxiety goes off the wall. So be very very careful with dhea and pregnenolone.
BHRT is easier to control and maintain plus much safer if used as topical, vaginal. Oral can be dangerous because of liver first pass problems even if it is BHRT.
Lots of hard fought information; I hope some of this is helpful. Find that BHRT hormone doctor who uses hormone testing, especially saliva tests. Everything will fall into place then.
Please let me know how you do with all of this. I will be thinking and concerned about you.
@kathleen1314 Thank you! The 6.5mg Intrarosa dose was way too high for me.
I'm 49 now but started experiencing signs of GSM at 47. My urologist put me on Vagifem which helped for five months. I had already had painful periods since my 20s which were making me homebound by my 40s.
In my 20s, I was diagnosed with IC. In my 40s, fibromyalgia and vulvodynia were added to my list. I've been sensitive to ingredients in shampoos, detergents, etc., since my 20s. I was recently re-patch tested showing similar sensitivities plus a new allergy to Monistat.
I switched to a menopause/hormone specialist farther away after when Vagifem failed me plus I was also developing headaches, losing hair, nails were breaking, my vagina was dry again and now crampy and my cycles had gone from debilitating for one week to debilitating for most of the month. Imvexxy helped for five months with a little topical compounded Estradiol. My existing obgyn was of little help except to say she thought I'd been living with endometriosis since my 20s and if I'd lived with it that long then I could until menopause. She lost interest. But thankfully she had someone on staff to do bladder instillations, which helped me on bad days.
I switched to a new gynecologist a year ago who saw the severity of my pain and after trialing two other meds my uterus ( a feeling for about two years) continued to feel like it would prolapse even though he and my pelvic floor PT said it would not. I did my exercises and wore a belly band. I was beat down and asked my new gyn to take my uterus out. He said it was limp and heavy, hence my inability to stand up straight or sit. My older relatives suggested removing my ovaries. I don't miss my uterus in the slightest. But, right now, I tremendously miss my ovaries even though I know their numbers were very close to menopause.
While seeing my current/new gyn, I added a new, local NP who has started her own business in hormone management to do my blood draws. My current gynecologist is retiring soon but will put me on with another one at his practice.
I have a dermatologist, too, who has overseen my vulvodynia for a few years.
But today and yesterday I was thinking I need a true BHRT menopause specialist who won't overload my lady parts with creams. My skin simply won't handle it.
I'm trying what I can right now from my gyn which is an Estradiol gel that I rub behind my knees and on my wrists, because my body was not absorbing the patch. I just had a blood draw yesterday to see how I'm doing on the gel. My gyn just added in a testosterone cream at a low dose to be rubbed on thin skin twice weekly. I have no libido.
He strongly advised me against any testosterone cream on the clitoris and labia. He'd seen clitotomegaly. My first menopause NP was very much for testosterone cream locally but the few times I tried it my skin turned hot so I told her no thanks.
It's a lot to navigate.
I do have both the micronized Progesterone 100mg as well as a compounded 50mg extended-release version. A few days ago the 100mg was giving me daytime depression so I stopped for two days but now I'm missing the calming, sleepy effect at bedtime.
I have a Progesterone cream that is supposed to be bioidentical. I rub it on my tummy some nights when I remember it.
I need to learn more about BHRT and what my body responds to best. I'm due to see my urologist next month. I see him every six months to get my urine checked, talk about IC pain and he's my Vagifem/Imvexxy back-up prescriber.
I'll look at the ZRT website. I really want one person who'll run bloodwork, educate me on BHRT, who is educated in GSM, will check my groin skin frequently for adverse effects and craft a plan.
Thank you for your detailed response. I will study it again and again.
Forgive me if I repeated myself from a previous post.
@kathleen1314 Thank you! The 6.5mg Intrarosa dose was way too high for me.
I'm 49 now but started experiencing signs of GSM at 47. My urologist put me on Vagifem which helped for five months. I had already had painful periods since my 20s which were making me homebound by my 40s.
In my 20s, I was diagnosed with IC. In my 40s, fibromyalgia and vulvodynia were added to my list. I've been sensitive to ingredients in shampoos, detergents, etc., since my 20s. I was recently re-patch tested showing similar sensitivities plus a new allergy to Monistat.
I switched to a menopause/hormone specialist farther away after when Vagifem failed me plus I was also developing headaches, losing hair, nails were breaking, my vagina was dry again and now crampy and my cycles had gone from debilitating for one week to debilitating for most of the month. Imvexxy helped for five months with a little topical compounded Estradiol. My existing obgyn was of little help except to say she thought I'd been living with endometriosis since my 20s and if I'd lived with it that long then I could until menopause. She lost interest. But thankfully she had someone on staff to do bladder instillations, which helped me on bad days.
I switched to a new gynecologist a year ago who saw the severity of my pain and after trialing two other meds my uterus ( a feeling for about two years) continued to feel like it would prolapse even though he and my pelvic floor PT said it would not. I did my exercises and wore a belly band. I was beat down and asked my new gyn to take my uterus out. He said it was limp and heavy, hence my inability to stand up straight or sit. My older relatives suggested removing my ovaries. I don't miss my uterus in the slightest. But, right now, I tremendously miss my ovaries even though I know their numbers were very close to menopause.
While seeing my current/new gyn, I added a new, local NP who has started her own business in hormone management to do my blood draws. My current gynecologist is retiring soon but will put me on with another one at his practice.
I have a dermatologist, too, who has overseen my vulvodynia for a few years.
But today and yesterday I was thinking I need a true BHRT menopause specialist who won't overload my lady parts with creams. My skin simply won't handle it.
I'm trying what I can right now from my gyn which is an Estradiol gel that I rub behind my knees and on my wrists, because my body was not absorbing the patch. I just had a blood draw yesterday to see how I'm doing on the gel. My gyn just added in a testosterone cream at a low dose to be rubbed on thin skin twice weekly. I have no libido.
He strongly advised me against any testosterone cream on the clitoris and labia. He'd seen clitotomegaly. My first menopause NP was very much for testosterone cream locally but the few times I tried it my skin turned hot so I told her no thanks.
It's a lot to navigate.
I do have both the micronized Progesterone 100mg as well as a compounded 50mg extended-release version. A few days ago the 100mg was giving me daytime depression so I stopped for two days but now I'm missing the calming, sleepy effect at bedtime.
I have a Progesterone cream that is supposed to be bioidentical. I rub it on my tummy some nights when I remember it.
I need to learn more about BHRT and what my body responds to best. I'm due to see my urologist next month. I see him every six months to get my urine checked, talk about IC pain and he's my Vagifem/Imvexxy back-up prescriber.
I'll look at the ZRT website. I really want one person who'll run bloodwork, educate me on BHRT, who is educated in GSM, will check my groin skin frequently for adverse effects and craft a plan.
Thank you for your detailed response. I will study it again and again.
Forgive me if I repeated myself from a previous post.
@blueskies1530
Your concerns about creams : Well, a BHRT specialist will use creams, topically and vaginally. This is the safest way to use any HRT.
I personally, have found that the body needs a good systemic level of hormone and then the vaginal can be just an estriol cream and hylauronic acid with a vaginal probiotic if needed.
Hormone tests:
A serum test will not accurately reflect a topical cream, serum tests are for oral hormones. For topical applications you need a saliva test. Saliva tests which have recently become much more accurate will reflect hormones at the cellular level where they are being used.
Your Progesterone:
micronized Progesterone 100mg, I am assuming prometrium, oral. The problem with this is that it has first pass liver syndrome, which may or may not cause problems. But I know that my hormone dr does use it especially for sleep issues because that first pass liver syndrome can also produce metabolites which help with sleep.
BUT....you also need to weigh in a fuller picture in your decision.... this is that Prometrium (micronized progesterone) undergoes extensive first-pass metabolism in the liver, where it is converted into metabolites like pregnanolone. These metabolites act on GABA receptors in the brain, promoting sedation and improved sleep. While generally safe, this metabolism can cause significant, though rarely, liver issues or severe dizziness
Locations to place BHRT creams:
The full Tummy area is not the best place to rub your progesterone cream for absorption. Progesterone BHRT cream is best applied to areas with thin skin and high capillary density for maximum absorption. Optimal sites include the inner wrists, inner arms, inner thighs, behind the knees, and lower abdomen. Rotating application sites is recommended to prevent skin irritation or receptor saturation.
General suggestions:
Ask your urologist about a dna urine analyis and vaginal dna analysis. My urology office does these, and it is beyond helpful.
You will probably need 3 doctors. One for gyn; one for hormones; and one for bladder. It is my experience that if you don't get an expert then you will have problems and need to repeat. It is rare to find say a GYN that does dna vaginally and does dna urine plus uses BHRT hormones. I haven't found one.
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Yes, a lack of estrogen, commonly occurring during menopause, breastfeeding, or following cancer treatments, can cause redness on the labia majora. Low estrogen causes vulvovaginal atrophy, making tissues thinner, drier, and more prone to irritation, inflammation, burning, and redness. This condition is often part of the genitourinary syndrome of menopause (GSM).
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2 Reactions@kathleen1314 Thank you very much. I am four months post-total hysterectomy. For a few weeks, Imvexxy + compounded Estradiol cream were sufficient, just as it was pre-hysterectomy. Then two months ago I tried Intrarosa for five weeks. I had a honeymoon period of three weeks with it: my libido mostly returned and I wasn't dry. Then I became irritable, hungry at 2am then my labia majora and minora turned red as did the entrance to my vagina. I tried rubbing on DHEA cream externally but it irritated my skin even more. I'm pretty sure I tried Imvexxy again but I was too far gone with a glowing red crotch. Shortly thereafter, I had a minor operation requiring Fluconzaole and an antibiotic. I ended up at my gyn's office. My irritated, thin skin developed a yeast infection. I'm six days into Terconazole along with topical Clotrimazole+Betamethasone. I gave in and inserted a Vagifem this afternoon thinking I was done with Terconazole but I realized I only have one night left so I think it'll be ok. My bladder is so sore without estrogen.
After all of this is done, I'm going to try Vagifem for as long as my delicate skin could possibly gain something from it then try going back to Imvexxy and using a limited amount of Estradiol cream externally.
I was told about the Estring. Are you familiar with it?
Sorry for the long post, but the GSM has been hell.
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Helpful -
Hug
1 Reaction@blueskies1530
Ok, Intrarosa may be the problem. Ai google lists the inflammation and redness as a know side effect of Intrarosa. Intrarosa is a non bioidentical high powered dhea.
Ai google explanation: "Intrarosa (prasterone) can cause vaginal and vulvar irritation, which may manifest as a red, inflamed, or burning sensation in the labia majora. "
I tried Intrarosa once on my urologist's suggestion. I even cut it into thirds. My testosterone shot off the chart.
My hormone dr was not pleased; he said that intrarosa is not bioidentical, so more dangerous, and it is an extremely high dose of DHEA and that was causing my problems. Lukily I only took a full dose or less due to cutting it into pieces.
You had a much larger dose.
Rubbing more dhea probably made the situation worse; I am sorry.
I still have my uterus and ovaries and until just recently my body produced estradiol and testosterone at good levels. So I just use topically estriol, progesterone and a tiny amount of testosterone plus Estriol vaginally. I am finding that those of us with and without a uterus need different interventions. For some reason the act of surgery to take the uterus/ovaries seems to also impact any organ making enough hormones, whereas my body until recently in my early 70s was making plenty of estradiol and testosterone. That has now changed. Sigh
What I would suggest is to find a hormone specialist who uses BHRT and hormone testing to check your levels. Progesterone is needed for everyone even if they don't have a uterus or ovaries; you need it for systemic health and your breasts. Progesterone also helps with sleep and with those anxiety menopause problems.
You can find a hormone dr specialist by calling your local compounder and asking for someone who uses BHRT and hormone testing.
Or you can use the ZRT website to search for providers that use ZRT testing, some will be doctors, some will be compounders.
https://myzrt.zrtlab.com/tools/findprovider
I believe that vagifem is bioidentical, but I have never used it.
Also, copilot can look at all the research and studies and give you some good pointers; you might ask it.
One more cautionary tale, DHEA pulls some major body levers. Some women can take DHEA and pregnenolone and that is their entire HRT. I am so jealous. My body hits those levers hard and huge jumps in everything happens and anxiety goes off the wall. So be very very careful with dhea and pregnenolone.
BHRT is easier to control and maintain plus much safer if used as topical, vaginal. Oral can be dangerous because of liver first pass problems even if it is BHRT.
Lots of hard fought information; I hope some of this is helpful. Find that BHRT hormone doctor who uses hormone testing, especially saliva tests. Everything will fall into place then.
Please let me know how you do with all of this. I will be thinking and concerned about you.
@kathleen1314 Thank you! The 6.5mg Intrarosa dose was way too high for me.
I'm 49 now but started experiencing signs of GSM at 47. My urologist put me on Vagifem which helped for five months. I had already had painful periods since my 20s which were making me homebound by my 40s.
In my 20s, I was diagnosed with IC. In my 40s, fibromyalgia and vulvodynia were added to my list. I've been sensitive to ingredients in shampoos, detergents, etc., since my 20s. I was recently re-patch tested showing similar sensitivities plus a new allergy to Monistat.
I switched to a menopause/hormone specialist farther away after when Vagifem failed me plus I was also developing headaches, losing hair, nails were breaking, my vagina was dry again and now crampy and my cycles had gone from debilitating for one week to debilitating for most of the month. Imvexxy helped for five months with a little topical compounded Estradiol. My existing obgyn was of little help except to say she thought I'd been living with endometriosis since my 20s and if I'd lived with it that long then I could until menopause. She lost interest. But thankfully she had someone on staff to do bladder instillations, which helped me on bad days.
I switched to a new gynecologist a year ago who saw the severity of my pain and after trialing two other meds my uterus ( a feeling for about two years) continued to feel like it would prolapse even though he and my pelvic floor PT said it would not. I did my exercises and wore a belly band. I was beat down and asked my new gyn to take my uterus out. He said it was limp and heavy, hence my inability to stand up straight or sit. My older relatives suggested removing my ovaries. I don't miss my uterus in the slightest. But, right now, I tremendously miss my ovaries even though I know their numbers were very close to menopause.
While seeing my current/new gyn, I added a new, local NP who has started her own business in hormone management to do my blood draws. My current gynecologist is retiring soon but will put me on with another one at his practice.
I have a dermatologist, too, who has overseen my vulvodynia for a few years.
But today and yesterday I was thinking I need a true BHRT menopause specialist who won't overload my lady parts with creams. My skin simply won't handle it.
I'm trying what I can right now from my gyn which is an Estradiol gel that I rub behind my knees and on my wrists, because my body was not absorbing the patch. I just had a blood draw yesterday to see how I'm doing on the gel. My gyn just added in a testosterone cream at a low dose to be rubbed on thin skin twice weekly. I have no libido.
He strongly advised me against any testosterone cream on the clitoris and labia. He'd seen clitotomegaly. My first menopause NP was very much for testosterone cream locally but the few times I tried it my skin turned hot so I told her no thanks.
It's a lot to navigate.
I do have both the micronized Progesterone 100mg as well as a compounded 50mg extended-release version. A few days ago the 100mg was giving me daytime depression so I stopped for two days but now I'm missing the calming, sleepy effect at bedtime.
I have a Progesterone cream that is supposed to be bioidentical. I rub it on my tummy some nights when I remember it.
I need to learn more about BHRT and what my body responds to best. I'm due to see my urologist next month. I see him every six months to get my urine checked, talk about IC pain and he's my Vagifem/Imvexxy back-up prescriber.
I'll look at the ZRT website. I really want one person who'll run bloodwork, educate me on BHRT, who is educated in GSM, will check my groin skin frequently for adverse effects and craft a plan.
Thank you for your detailed response. I will study it again and again.
Forgive me if I repeated myself from a previous post.
@blueskies1530
Your concerns about creams : Well, a BHRT specialist will use creams, topically and vaginally. This is the safest way to use any HRT.
I personally, have found that the body needs a good systemic level of hormone and then the vaginal can be just an estriol cream and hylauronic acid with a vaginal probiotic if needed.
Hormone tests:
A serum test will not accurately reflect a topical cream, serum tests are for oral hormones. For topical applications you need a saliva test. Saliva tests which have recently become much more accurate will reflect hormones at the cellular level where they are being used.
Your Progesterone:
micronized Progesterone 100mg, I am assuming prometrium, oral. The problem with this is that it has first pass liver syndrome, which may or may not cause problems. But I know that my hormone dr does use it especially for sleep issues because that first pass liver syndrome can also produce metabolites which help with sleep.
BUT....you also need to weigh in a fuller picture in your decision.... this is that Prometrium (micronized progesterone) undergoes extensive first-pass metabolism in the liver, where it is converted into metabolites like pregnanolone. These metabolites act on GABA receptors in the brain, promoting sedation and improved sleep. While generally safe, this metabolism can cause significant, though rarely, liver issues or severe dizziness
Locations to place BHRT creams:
The full Tummy area is not the best place to rub your progesterone cream for absorption. Progesterone BHRT cream is best applied to areas with thin skin and high capillary density for maximum absorption. Optimal sites include the inner wrists, inner arms, inner thighs, behind the knees, and lower abdomen. Rotating application sites is recommended to prevent skin irritation or receptor saturation.
General suggestions:
Ask your urologist about a dna urine analyis and vaginal dna analysis. My urology office does these, and it is beyond helpful.
You will probably need 3 doctors. One for gyn; one for hormones; and one for bladder. It is my experience that if you don't get an expert then you will have problems and need to repeat. It is rare to find say a GYN that does dna vaginally and does dna urine plus uses BHRT hormones. I haven't found one.
Do you insert a probiotic in your vagina? I already use oral probiotics for vaginal flora.
Where do you get BHRT creams and ensure each dose is accurate?