Study the change in serum estrogen level based on the method of vaginal cream application (applicator vs fingertip application) and Measure patient satisfaction with vaginal estrogen cream application based on the method of application using a validated patient questionnaire (Likert scale).
patients who are postmenopausal for at least 1 year (since their last menses)
patients who qualify for treatment with vaginal estrogen cream and are willing to complete the treatment
English speaking patients
patients should be able to self-apply the vaginal estrogen cream using the applicator method and the fingertip application
pre and perimenopausal women
contraindication to estrogen therapy (Deep vein thrombosis, history or active cancer)
women who are not able to self apply the vaginal estrogen cream
vaginal bleeding of unknown origin