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    Hormone Replacement Gels or Creams
    VAMcCall posted:
    I am 48 1/2, had total hysterectomy in June 2000 so, have been on HRT since then as my GYN explained I would need forever. I have tried several diff types over the years - changing most times based on costs. I am currently Diabetic & primary physician who treats me for that insisted I not take a oral HRT any longer as could cause problems with the Diabetes meds - - need something topical. Problem is - my prescription plan doesnt cover a lot on the topicals so, I would have to pay too much "out of pocket" with all the other meds I'm now on. Any suggestions for something I can possibly afford better - something that's OTC or something?
    Rhondamay responded:
    Femring is an estrogen distributing ring that is inserted into the vagina and lasts for 90 days. It is effective and easy to use. You don't even know it is there. It is not as messy as the creams you inject. The cost is about $90 to $100 a ring. For three months that is not too bad. It is prescription not OTC. I hope this helps. Good luck VA!
    Mary Jane Minkin, MD replied to Rhondamay's response:
    Dear Rhondamay,
    The Femring is indeed a very good product, and it certainly does help moisturize the vagina. One thing that our readers need to be aware of: the Femring gives a moderate amount of estrogen into the blood stream-so if you have a uterus, and are post menopausal (you've stopped having periods) you need to take some progesterone with it. If you just want to get moisture in your vagina, and don't want any systemic absorption, you should get the Estring, which is a much smaller amount of estrogen.
    Both good products: just depends on whether you want to get some estrogen into the blood stream or not.
    Good luck,
    Mary Jane
    Mary Jane Minkin, MD responded:
    Dear VAMcCall,
    Rhondamay made a very good suggestion on the Femring; and since you have had a hysterectomy, you don't need any progestins. Another relatively inexpensive option: there is a generic estrogen transdermal patch, called the Mylan patch-you can get the 0.1 patch (which is the highest dose)-and cut it up into smaller pieces (like even into quarters)-and you can use that-half of the 0.1 patch would be ball park equivalent to a 1 mg tablet of estradiol. So these are I would think your least expensive options out there.
    Good luck,
    Mary Jane

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    For more information, visit the North American Menopause Society website