Estrogen Access · $125, only if approved
When pelvic floor PT isn’t enough on its own, this is usually why.
A doctor’s review, a vaginal estrogen prescription if it’s right for you, and your PT kept in the loop. $125.
Who it’s for
Vaginal dryness
Burning
Irritation
Pain with sex
Two or more UTIs in a year
PT progress that has stalled
How it works
01.
Short online intake
Tell us about your symptoms and health history online.
02.
Dr. Fincher reviews it
Usually within a couple of days.
03.
Prescription sent to your pharmacy
If vaginal estrogen is appropriate for you.
What is vaginal estrogen?
Vaginal estrogen is a low dose of estrogen placed in the vagina. It treats dryness, pain with sex, and urinary symptoms where they start, and very little reaches the rest of the body.
Vaginal estrogen
Systemic hormone therapy
How it’s used
What it treats
Blood estrogen levels
Needs a second hormone?
Common questions
Is it safe?
Two large studies followed tens of thousands of women for up to 18 years. Vaginal estrogen users had no higher risk of heart disease, stroke, blood clots, breast cancer, or endometrial cancer than non-users. Guidelines say it does not raise the risk of endometrial cancer.
How much gets into my blood?
Very little. Low-dose vaginal estrogen works where it's placed, and only a tiny amount is absorbed, so it barely changes the estrogen level in your blood. That's why it doesn't need a second hormone to protect the uterus.
What about the warning on the label?
The old boxed warning was based on studies of whole-body hormones, not vaginal estrogen. In November 2025, the FDA began removing boxed warnings from menopause hormone therapy labels.
What does the research show for UTIs?
Urology guidelines recommend vaginal estrogen to lower the risk of repeat UTIs. In a 2026 study of nearly 1.9 million women with recurrent UTIs, a prescription for vaginal estrogen was linked to lower rates of sepsis, hospital stays, and death.
Who can use it?
People in perimenopause or after menopause, and some patients who are breastfeeding. Guidelines set no age cutoff, and it can be used for as long as you need it. With a history of breast cancer, it's a shared decision with your cancer care team.
How do I use it?
It comes as a cream, a small tablet or insert, or a soft ring. Tablets and inserts are used twice a week, and creams two or three times a week, often after a short daily start. The ring is changed every 3 months.
Does it affect my partner?
Tablets, inserts, and the ring stay in place during sex. With cream, apply it at bedtime or after sex rather than before, and don't use it as a lubricant.
Sources: Crandall et al., Menopause, 2018. Bhupathiraju et al., Menopause, 2019. AUA/SUFU/AUGS Guideline on Genitourinary Syndrome of Menopause, 2025. The Menopause Society, 2020 GSM Position Statement. U.S. FDA, November 10, 2025. LaClair et al., Urology, 2026. General information, not medical advice.
What’s included
✓ A 12-month prescription, if appropriate
✓ An optional 20-minute video call, before or after
✓ A note to your PT, with your consent
Insurance
Visits are cash-pay, and the $125 is charged only if Dr. Fincher approves treatment. Medication is often covered by insurance or inexpensive without it.
About Dr. Fincher
Dr. Danielle Fincher, MD, MPH, FAAFP, is a board-certified family medicine physician focused on women’s health, sexual health, and menopause care.
She brings more than a decade of clinical and public health experience, including full-spectrum family medicine and obstetrics in Washington, DC.
She reviews Estrogen Access intakes herself and decides whether treatment is right for you.
Frequently asked questions
Who is Estrogen Access for?
Adults with vaginal dryness, burning, or irritation, pain with sex or exams, recurrent UTIs, or pelvic floor PT progress that has stalled. It's often perimenopause, menopause, or breastfeeding. You need to be in Virginia or DC at the time of your visit.
What happens after I start?
You complete a short intake online. Dr. Fincher reviews it, usually within a couple of days, and decides whether vaginal estrogen is appropriate. If you'd like to talk, you can book an optional 20-minute video call with her, before or after your prescription.
What if vaginal estrogen isn't right for me?
You aren't charged. Dr. Fincher will let you know why and suggest a next step that makes sense for you.
What does it cost? Does insurance cover it?
$125, cash-pay, charged only if Dr. Fincher approves treatment. That covers a 12-month prescription sent to your pharmacy and an optional 20-minute video call. The medication is often covered by insurance or inexpensive without it, and we can give you a superbill to submit to your insurer.
Will my physical therapist hear from you?
Only with your consent. If you agree, we send your PT a short note on what was prescribed so your care stays connected.
Ready to start?
A short online intake, reviewed by Dr. Fincher. $125, charged only if approved.
The information on this page is general and is not medical advice. Estrogen Access starts with an online intake, and Dr. Fincher decides whether a prescription is appropriate for you. Services are available to patients located in Virginia and DC. If you think you have a medical emergency, call 911.