About Fountain Telemedicine

Part 1: About Your Medication

What is the medication you've prescribed?

It's a compounded cream containing 0.01% estradiol (E2) — the same form of estrogen your ovaries produced before menopause — in a smooth, well-tolerated cream base called Ellage. You apply a small amount intravaginally using a calibrated applicator. The cream delivers estradiol directly to the tissues that need it.

Is compounded medication safe?

Yes, when it's made by a licensed compounding pharmacy that follows strict quality and sterility standards. Fountain partners only with accredited compounding pharmacies that test every batch and meet federal compounding regulations. Compounding allows us to deliver the exact strength and formulation that's right for you, in a base that's gentle on sensitive tissue.

How is this different from systemic estradiol (E2) cream?

Systemic estradiol cream is applied to the skin (typically the inner thigh or arm) and absorbed into your bloodstream, where it goes on to treat the symptoms estrogen affects throughout your body — hot flashes, sleep, mood, bone health, and so on.

Vaginal estradiol cream works locally. Most of the medication stays in the vaginal and vulvar tissues where you apply it, and only a very small amount enters your bloodstream. That's by design. The goal isn't to raise your overall estrogen level (your systemic cream does that). The goal is to restore the local tissues that don't fully respond to systemic doses, even when systemic levels are well controlled.

How long until I feel better?

Most women notice meaningful improvement within 2–4 weeks. Full benefit — including resolution of pain with intercourse and a reduction in urinary symptoms — typically takes 8–12 weeks of consistent use. If you're not noticing any improvement after about 8 weeks, message your Fountain clinician so we can adjust your protocol.

What is the medication you've prescribed?

It's a compounded cream containing 0.01% estradiol (E2) — the same form of estrogen your ovaries produced before menopause — in a smooth, well-tolerated cream base called Ellage. You apply a small amount intravaginally using a calibrated applicator. The cream delivers estradiol directly to the tissues that need it.

Is compounded medication safe?

Yes, when it's made by a licensed compounding pharmacy that follows strict quality and sterility standards. Fountain partners only with accredited compounding pharmacies that test every batch and meet federal compounding regulations. Compounding allows us to deliver the exact strength and formulation that's right for you, in a base that's gentle on sensitive tissue.

How is this different from systemic estradiol (E2) cream?

Systemic estradiol cream is applied to the skin (typically the inner thigh or arm) and absorbed into your bloodstream, where it goes on to treat the symptoms estrogen affects throughout your body — hot flashes, sleep, mood, bone health, and so on.

Vaginal estradiol cream works locally. Most of the medication stays in the vaginal and vulvar tissues where you apply it, and only a very small amount enters your bloodstream. That's by design. The goal isn't to raise your overall estrogen level (your systemic cream does that). The goal is to restore the local tissues that don't fully respond to systemic doses, even when systemic levels are well controlled.

How long until I feel better?

Most women notice meaningful improvement within 2–4 weeks. Full benefit — including resolution of pain with intercourse and a reduction in urinary symptoms — typically takes 8–12 weeks of consistent use. If you're not noticing any improvement after about 8 weeks, message your Fountain clinician so we can adjust your protocol.

Part 2: How to Use Your Cream

How do I apply the cream intravaginally?

Step by step:

Wash your hands with soap and water.
Remove the cap from the tube.
Screw the calibrated applicator onto the tube.
Gently squeeze the tube until cream fills the applicator to the 0.5 g mark.
Unscrew the applicator from the tube and replace the tube cap.
Lie down on your back, knees bent. Insert the applicator into the vagina as far as it comfortably goes.
Slowly press the plunger to release the cream.
Remove the applicator. Wash it with warm soapy water, rinse, and air dry.
Wash your hands again.

What about the vulva — should I apply cream there too?

Often, yes. Many GSM symptoms — dryness, soreness, irritation around the vaginal opening, sensitivity to clothing or touch, pain at the entrance during sex — come from changes in the vulvar tissue, not just the vaginal canal. Applying a small amount of cream directly to the vulva treats those symptoms at the source.

If your Fountain clinician has recommended vulvar application as part of your protocol: after your intravaginal dose, place a small pea-sized amount of cream onto a clean fingertip and gently massage it onto the vulva, focusing on the labia minora and the vaginal opening (the introitus). This is typically done at the same time as your intravaginal dose.

Some women have primarily vulvar symptoms and use the cream vulvar-only, without intravaginal application. If that's your situation, your clinician will give you specific instructions. Either way, message your care team if you're unsure where your symptoms are or how to apply the cream — we're happy to walk you through it.

When should I apply it?

At bedtime. Applying overnight gives the cream the longest possible contact with the tissues that need it, and minimizes leakage during the day. A panty liner overnight is optional, but some women prefer it during the first week or two.

What if I miss a dose?

If you miss a nightly dose during the first 14 days (induction phase), apply it the next morning when you remember, and resume your regular bedtime schedule that night. Don't double up. If you miss a maintenance dose (2–3 times per week), simply apply it the next night and continue your schedule. A single missed dose won't undo your progress.

Can I have sex while using vaginal estradiol?

Yes — this is one of the main reasons we prescribe it. Once your tissues have begun to heal (typically after the first 2–4 weeks), most women find intercourse becomes comfortable again.

A few practical notes. The cream itself can transfer to a partner if intercourse happens shortly after application. To avoid this, apply your dose at bedtime and don't have intercourse for at least 8–12 hours afterward, or skip your dose on the night you have intercourse and apply it the next night. Vaginal estradiol is not a contraceptive and does not prevent pregnancy or sexually transmitted infections.

Should I use a lubricant too?

Yes, especially in the first few weeks before the estradiol has fully restored your tissues. A water-based or silicone-based lubricant during intercourse is fine and won't interfere with the cream. Avoid oil-based lubricants if you use latex condoms — they can break down latex.

What if some of the cream leaks out the next day?

A small amount of leakage is normal and not a sign you need a higher dose. The cream is designed to be absorbed locally, and what hasn't been absorbed by morning is harmless. A panty liner can manage any residual cream and protect your underwear.

Can I use this during my period (if I still have one)?

Yes. Continue using the cream on your normal schedule. If bleeding makes application uncomfortable, you can pause for a day or two — it won't undo your progress.

How do I apply the cream intravaginally?

Step by step:

Wash your hands with soap and water.
Remove the cap from the tube.
Screw the calibrated applicator onto the tube.
Gently squeeze the tube until cream fills the applicator to the 0.5 g mark.
Unscrew the applicator from the tube and replace the tube cap.
Lie down on your back, knees bent. Insert the applicator into the vagina as far as it comfortably goes.
Slowly press the plunger to release the cream.
Remove the applicator. Wash it with warm soapy water, rinse, and air dry.
Wash your hands again.

What about the vulva — should I apply cream there too?

Often, yes. Many GSM symptoms — dryness, soreness, irritation around the vaginal opening, sensitivity to clothing or touch, pain at the entrance during sex — come from changes in the vulvar tissue, not just the vaginal canal. Applying a small amount of cream directly to the vulva treats those symptoms at the source.

If your Fountain clinician has recommended vulvar application as part of your protocol: after your intravaginal dose, place a small pea-sized amount of cream onto a clean fingertip and gently massage it onto the vulva, focusing on the labia minora and the vaginal opening (the introitus). This is typically done at the same time as your intravaginal dose.

Some women have primarily vulvar symptoms and use the cream vulvar-only, without intravaginal application. If that's your situation, your clinician will give you specific instructions. Either way, message your care team if you're unsure where your symptoms are or how to apply the cream — we're happy to walk you through it.

When should I apply it?

At bedtime. Applying overnight gives the cream the longest possible contact with the tissues that need it, and minimizes leakage during the day. A panty liner overnight is optional, but some women prefer it during the first week or two.

What if I miss a dose?

If you miss a nightly dose during the first 14 days (induction phase), apply it the next morning when you remember, and resume your regular bedtime schedule that night. Don't double up. If you miss a maintenance dose (2–3 times per week), simply apply it the next night and continue your schedule. A single missed dose won't undo your progress.

Can I have sex while using vaginal estradiol?

Yes — this is one of the main reasons we prescribe it. Once your tissues have begun to heal (typically after the first 2–4 weeks), most women find intercourse becomes comfortable again.

A few practical notes. The cream itself can transfer to a partner if intercourse happens shortly after application. To avoid this, apply your dose at bedtime and don't have intercourse for at least 8–12 hours afterward, or skip your dose on the night you have intercourse and apply it the next night. Vaginal estradiol is not a contraceptive and does not prevent pregnancy or sexually transmitted infections.

Should I use a lubricant too?

Yes, especially in the first few weeks before the estradiol has fully restored your tissues. A water-based or silicone-based lubricant during intercourse is fine and won't interfere with the cream. Avoid oil-based lubricants if you use latex condoms — they can break down latex.

What if some of the cream leaks out the next day?

A small amount of leakage is normal and not a sign you need a higher dose. The cream is designed to be absorbed locally, and what hasn't been absorbed by morning is harmless. A panty liner can manage any residual cream and protect your underwear.

Can I use this during my period (if I still have one)?

Yes. Continue using the cream on your normal schedule. If bleeding makes application uncomfortable, you can pause for a day or two — it won't undo your progress.

Part 3: Side Effects & What to Expect

What side effects might I notice?

Most side effects are mild and improve within the first 2–4 weeks as your tissues adjust. The most common ones:

Mild burning, stinging, or itching at the application site
Increased vaginal discharge (often a sign the tissues are rehydrating — this is usually a good sign)
Light spotting in the first few weeks, especially if your tissues were very thin before treatment

Less common, and uncommon at the low doses used here:

Mild breast tenderness
Headache

If any of these are severe, persistent past the first month, or worrying to you, message your Fountain clinician. We can adjust your dose, frequency, or formulation.

Will this cause weight gain or mood changes?

Vaginal estradiol delivers a very low dose locally, with minimal systemic absorption. Significant weight gain or mood changes from the vaginal cream alone are uncommon. If you notice these symptoms, they're more likely related to your systemic HRT, your menopause stage, or another factor — message us so we can sort it out.

Will my partner be affected?

Vaginal estradiol can transfer in small amounts during sexual contact if intercourse happens shortly after application. Apply at bedtime and allow 8–12 hours before intercourse, or skip the dose on intercourse nights. Long-term, regular partner exposure to small amounts of vaginal estradiol is not believed to cause meaningful harm, but minimizing transfer is the responsible approach.

Could this cause spotting or bleeding?

A small amount of spotting in the first few weeks is common and usually reflects the healing of fragile tissues. It should resolve within the first month.

Any new, unexplained, or heavy vaginal bleeding after menopause — or bleeding that starts or returns after the first month of treatment — should be evaluated. Message your Fountain clinician promptly so we can determine whether further evaluation is needed.

What side effects might I notice?

Most side effects are mild and improve within the first 2–4 weeks as your tissues adjust. The most common ones:

Mild burning, stinging, or itching at the application site
Increased vaginal discharge (often a sign the tissues are rehydrating — this is usually a good sign)
Light spotting in the first few weeks, especially if your tissues were very thin before treatment

Less common, and uncommon at the low doses used here:

Mild breast tenderness
Headache

If any of these are severe, persistent past the first month, or worrying to you, message your Fountain clinician. We can adjust your dose, frequency, or formulation.

Will this cause weight gain or mood changes?

Vaginal estradiol delivers a very low dose locally, with minimal systemic absorption. Significant weight gain or mood changes from the vaginal cream alone are uncommon. If you notice these symptoms, they're more likely related to your systemic HRT, your menopause stage, or another factor — message us so we can sort it out.

Will my partner be affected?

Vaginal estradiol can transfer in small amounts during sexual contact if intercourse happens shortly after application. Apply at bedtime and allow 8–12 hours before intercourse, or skip the dose on intercourse nights. Long-term, regular partner exposure to small amounts of vaginal estradiol is not believed to cause meaningful harm, but minimizing transfer is the responsible approach.

Could this cause spotting or bleeding?

A small amount of spotting in the first few weeks is common and usually reflects the healing of fragile tissues. It should resolve within the first month.

Any new, unexplained, or heavy vaginal bleeding after menopause — or bleeding that starts or returns after the first month of treatment — should be evaluated. Message your Fountain clinician promptly so we can determine whether further evaluation is needed.

Part 4: Understanding GSM

What is GSM?

GSM stands for genitourinary syndrome of menopause. It's a medical term for the cluster of symptoms many women develop in and around the vulva, vagina, and lower urinary tract as estrogen levels decline during perimenopause and menopause.

Common symptoms include:

Vaginal dryness, burning, or itching
Pain, soreness, or bleeding during or after sex
Decreased natural lubrication and reduced arousal
A feeling of tightness, narrowing, or loss of elasticity
Urinary urgency or needing to urinate frequently
Burning with urination, even when no infection is present
Recurrent urinary tract infections (UTIs)

What causes GSM?

Estrogen keeps the tissues of the vulva, vagina, and urinary tract thick, elastic, and well-lubricated. As estrogen declines, those tissues become thinner, drier, less elastic, and more fragile. Blood flow decreases, the vaginal pH shifts, and the natural balance of healthy bacteria changes — which is why UTIs and irritation become more common.

Will GSM go away on its own?

No. Unlike hot flashes, which often improve over time, GSM is progressive. Without treatment, symptoms tend to gradually get worse because the underlying cause — low estrogen in those tissues — doesn't reverse on its own.

How common is GSM?

Very. Studies estimate that 50–70% of postmenopausal women experience GSM symptoms, and the number rises with time since menopause. Despite how common it is, most women never bring it up with a clinician — which is part of why we wrote this guide.

I'm already on systemic HRT. Why do I also need vaginal estradiol?

Systemic HRT does a great job treating hot flashes, night sweats, mood symptoms, sleep disturbance, and bone health. But the doses used for systemic treatment often aren't high enough to fully restore the vaginal and vulvar tissues, because those tissues have their own local estrogen needs.

Adding low-dose vaginal estradiol delivers estrogen directly to the tissues that need it, with very little entering your bloodstream. For many women on systemic HRT, this combination is what finally resolves persistent dryness, painful intercourse, and recurrent UTIs.

What is GSM?

GSM stands for genitourinary syndrome of menopause. It's a medical term for the cluster of symptoms many women develop in and around the vulva, vagina, and lower urinary tract as estrogen levels decline during perimenopause and menopause.

Common symptoms include:

Vaginal dryness, burning, or itching
Pain, soreness, or bleeding during or after sex
Decreased natural lubrication and reduced arousal
A feeling of tightness, narrowing, or loss of elasticity
Urinary urgency or needing to urinate frequently
Burning with urination, even when no infection is present
Recurrent urinary tract infections (UTIs)

What causes GSM?

Estrogen keeps the tissues of the vulva, vagina, and urinary tract thick, elastic, and well-lubricated. As estrogen declines, those tissues become thinner, drier, less elastic, and more fragile. Blood flow decreases, the vaginal pH shifts, and the natural balance of healthy bacteria changes — which is why UTIs and irritation become more common.

Will GSM go away on its own?

No. Unlike hot flashes, which often improve over time, GSM is progressive. Without treatment, symptoms tend to gradually get worse because the underlying cause — low estrogen in those tissues — doesn't reverse on its own.

How common is GSM?

Very. Studies estimate that 50–70% of postmenopausal women experience GSM symptoms, and the number rises with time since menopause. Despite how common it is, most women never bring it up with a clinician — which is part of why we wrote this guide.

I'm already on systemic HRT. Why do I also need vaginal estradiol?

Systemic HRT does a great job treating hot flashes, night sweats, mood symptoms, sleep disturbance, and bone health. But the doses used for systemic treatment often aren't high enough to fully restore the vaginal and vulvar tissues, because those tissues have their own local estrogen needs.

Adding low-dose vaginal estradiol delivers estrogen directly to the tissues that need it, with very little entering your bloodstream. For many women on systemic HRT, this combination is what finally resolves persistent dryness, painful intercourse, and recurrent UTIs.

Part 5: Safety and Who Should Not Use This

Who should not use vaginal estradiol?

Vaginal estradiol is not appropriate for women with:

Known or suspected pregnancy, or current breastfeeding
Undiagnosed abnormal vaginal bleeding
An active estrogen-dependent cancer (such as current breast cancer or endometrial cancer)
Known hypersensitivity to estradiol or any of the ingredients in the cream base

Who should talk to us first before starting?

If you have a personal history of breast cancer, or if you are currently taking an aromatase inhibitor (such as anastrozole, letrozole, or exemestane), please discuss starting vaginal estradiol with both your oncologist and your Fountain clinician before beginning treatment. Current guidance from the American Urological Association supports the safety of low-dose vaginal estrogen in most breast cancer survivors, but women on aromatase inhibitors warrant individualized review.

How safe is vaginal estradiol overall?

Vaginal estradiol at the low doses used here has a strong safety record. Because so little of the medication reaches the bloodstream, the risks sometimes associated with higher-dose systemic estrogen — clotting, cardiovascular events, and so on — are not meaningfully increased by low-dose vaginal estradiol. The American Urological Association and The Menopause Society both endorse low-dose vaginal estrogen as a safe and effective treatment for GSM, including in women with cardiovascular history, prior blood clots, and most other conditions that have historically appeared on systemic-estrogen warning labels.

That said, it's good to know what your body is doing. Continue your routine preventive care: annual exams, age-appropriate mammograms, and any other screenings your primary care provider recommends. Report any new or unexpected symptoms to your Fountain clinician.

Will this affect my other medications?

Drug interactions with low-dose vaginal estradiol are uncommon because so little reaches the bloodstream. Make sure your Fountain clinician has your full current medication list, including over-the-counter products and supplements, so we can flag anything worth watching.

Do I need lab work or monitoring?

No. Lab monitoring is not required for vaginal estradiol. The dose is low and locally acting, and routine bloodwork doesn't add useful information. Continue your routine preventive care with your primary care provider.

Who should not use vaginal estradiol?

Vaginal estradiol is not appropriate for women with:

Known or suspected pregnancy, or current breastfeeding
Undiagnosed abnormal vaginal bleeding
An active estrogen-dependent cancer (such as current breast cancer or endometrial cancer)
Known hypersensitivity to estradiol or any of the ingredients in the cream base

Who should talk to us first before starting?

If you have a personal history of breast cancer, or if you are currently taking an aromatase inhibitor (such as anastrozole, letrozole, or exemestane), please discuss starting vaginal estradiol with both your oncologist and your Fountain clinician before beginning treatment. Current guidance from the American Urological Association supports the safety of low-dose vaginal estrogen in most breast cancer survivors, but women on aromatase inhibitors warrant individualized review.

How safe is vaginal estradiol overall?

Vaginal estradiol at the low doses used here has a strong safety record. Because so little of the medication reaches the bloodstream, the risks sometimes associated with higher-dose systemic estrogen — clotting, cardiovascular events, and so on — are not meaningfully increased by low-dose vaginal estradiol. The American Urological Association and The Menopause Society both endorse low-dose vaginal estrogen as a safe and effective treatment for GSM, including in women with cardiovascular history, prior blood clots, and most other conditions that have historically appeared on systemic-estrogen warning labels.

That said, it's good to know what your body is doing. Continue your routine preventive care: annual exams, age-appropriate mammograms, and any other screenings your primary care provider recommends. Report any new or unexpected symptoms to your Fountain clinician.

Will this affect my other medications?

Drug interactions with low-dose vaginal estradiol are uncommon because so little reaches the bloodstream. Make sure your Fountain clinician has your full current medication list, including over-the-counter products and supplements, so we can flag anything worth watching.

Do I need lab work or monitoring?

No. Lab monitoring is not required for vaginal estradiol. The dose is low and locally acting, and routine bloodwork doesn't add useful information. Continue your routine preventive care with your primary care provider.

Part 6: When to Reach Out

When should I message my Fountain care team?

Message us through the Fountain app or your patient portal for any of the following:

Symptoms not improving after 8 weeks of consistent use
Persistent burning, irritation, or discharge that doesn't resolve in the first month
New or unexplained vaginal bleeding after the first month of use
Persistent or bothersome side effects
Any new diagnosis or new medication that might affect your protocol
Anything that doesn't feel right — message us anytime, 24/7

When should I seek urgent in-person care?

Two situations warrant urgent in-person evaluation rather than messaging us. First, signs of a severe allergic reaction — swelling of the face, lips, tongue, or throat, or trouble breathing — call 911 or go to the nearest emergency room. Second, any heavy or prolonged unexplained vaginal bleeding should be evaluated promptly by a clinician in person. For everything else, message your Fountain care team and we'll help you decide on the right next step.

When should I message my Fountain care team?

Message us through the Fountain app or your patient portal for any of the following:

Symptoms not improving after 8 weeks of consistent use
Persistent burning, irritation, or discharge that doesn't resolve in the first month
New or unexplained vaginal bleeding after the first month of use
Persistent or bothersome side effects
Any new diagnosis or new medication that might affect your protocol
Anything that doesn't feel right — message us anytime, 24/7

When should I seek urgent in-person care?

Two situations warrant urgent in-person evaluation rather than messaging us. First, signs of a severe allergic reaction — swelling of the face, lips, tongue, or throat, or trouble breathing — call 911 or go to the nearest emergency room. Second, any heavy or prolonged unexplained vaginal bleeding should be evaluated promptly by a clinician in person. For everything else, message your Fountain care team and we'll help you decide on the right next step.

Part 7: Refills, Storage, and Day-to-Day

How do I refill my prescription?

Your first prescription is a 90-day supply that includes the 14-day induction phase. After that, your refills are 90-day maintenance supplies and are scheduled automatically through your Fountain account. You'll get a reminder before each refill ships. If you'd like to pause, change, or cancel, message your care team any time.

How should I store the cream?

Store at room temperature, away from direct sunlight, heat, and moisture. The bathroom medicine cabinet is fine if it doesn't get steamy; a bedside drawer is even better. Keep it out of reach of children and pets. Do not freeze. Check the expiration date on the tube — don't use cream past its expiration.

What if I'm traveling?

Pack the cream in your carry-on in case checked luggage is delayed or exposed to extreme temperatures. The applicator can travel in your toiletry bag. If you'll be away from home longer than your supply allows, message your care team a few weeks ahead and we'll arrange an early refill.

What if I run out before my refill arrives?

Message your Fountain care team. We'll help bridge the gap. Don't substitute another estrogen product without checking with us first.

How do I dispose of an empty or expired tube?

Empty tubes can go in your regular trash. For an expired tube with cream still inside, the safest disposal is at a pharmacy take-back location. If that's not available, mix the remaining cream with something undesirable (used coffee grounds or cat litter) in a sealed bag, then put it in the trash. Don't flush it.

Who do I contact if I have a question that isn't covered here?

Your Fountain care team is available through the app or patient portal anytime, 24/7. We'd rather hear from you than have you guess. No question is too small.

How do I refill my prescription?

Your first prescription is a 90-day supply that includes the 14-day induction phase. After that, your refills are 90-day maintenance supplies and are scheduled automatically through your Fountain account. You'll get a reminder before each refill ships. If you'd like to pause, change, or cancel, message your care team any time.

How should I store the cream?

Store at room temperature, away from direct sunlight, heat, and moisture. The bathroom medicine cabinet is fine if it doesn't get steamy; a bedside drawer is even better. Keep it out of reach of children and pets. Do not freeze. Check the expiration date on the tube — don't use cream past its expiration.

What if I'm traveling?

Pack the cream in your carry-on in case checked luggage is delayed or exposed to extreme temperatures. The applicator can travel in your toiletry bag. If you'll be away from home longer than your supply allows, message your care team a few weeks ahead and we'll arrange an early refill.

What if I run out before my refill arrives?

Message your Fountain care team. We'll help bridge the gap. Don't substitute another estrogen product without checking with us first.

How do I dispose of an empty or expired tube?

Empty tubes can go in your regular trash. For an expired tube with cream still inside, the safest disposal is at a pharmacy take-back location. If that's not available, mix the remaining cream with something undesirable (used coffee grounds or cat litter) in a sealed bag, then put it in the trash. Don't flush it.

Who do I contact if I have a question that isn't covered here?

Your Fountain care team is available through the app or patient portal anytime, 24/7. We'd rather hear from you than have you guess. No question is too small.

A Final Word

GSM is one of the most undertreated conditions in women's health, and it doesn't have to be the way you live. Vaginal estradiol is one of the best-studied, most effective treatments we have for the dryness, pain, and urinary symptoms that come with declining estrogen. Used consistently as prescribed, it can restore comfort, intimacy, and confidence — and that's the whole point of why we offer it.

If you have questions, message us. If something doesn't feel right, message us. That's what your Fountain care team is here for.

GSM is one of the most undertreated conditions in women's health, and it doesn't have to be the way you live. Vaginal estradiol is one of the best-studied, most effective treatments we have for the dryness, pain, and urinary symptoms that come with declining estrogen. Used consistently as prescribed, it can restore comfort, intimacy, and confidence — and that's the whole point of why we offer it.

If you have questions, message us. If something doesn't feel right, message us. That's what your Fountain care team is here for.

Important Disclaimers

About this medication

Estradiol vaginal cream prescribed by Fountain is a compounded medication, prepared by a licensed compounding pharmacy partner of Fountain in accordance with applicable state and federal regulations. Compounded medications are not reviewed or approved by the U.S. Food and Drug Administration (FDA) for safety, effectiveness, or quality in the same way as commercially manufactured prescription products.

Prescription requirement

This medication is available only by prescription, following an evaluation by a licensed Fountain clinician. Use only as prescribed. Do not share this medication with anyone else.

Individual results may vary

The information in this guide reflects general clinical experience and published medical literature on vaginal estradiol therapy. Individual response to treatment varies. The information here is educational and is not a substitute for personalized medical advice from your Fountain clinician.

State availability

Fountain services and prescription products are available only in states where Fountain's affiliated medical practices are authorized to operate. Availability and specific protocols may vary by state. Your Fountain clinician will confirm whether this medication is available to you based on your state of residence.

About this medication

Estradiol vaginal cream prescribed by Fountain is a compounded medication, prepared by a licensed compounding pharmacy partner of Fountain in accordance with applicable state and federal regulations. Compounded medications are not reviewed or approved by the U.S. Food and Drug Administration (FDA) for safety, effectiveness, or quality in the same way as commercially manufactured prescription products.

Prescription requirement

This medication is available only by prescription, following an evaluation by a licensed Fountain clinician. Use only as prescribed. Do not share this medication with anyone else.

Individual results may vary

The information in this guide reflects general clinical experience and published medical literature on vaginal estradiol therapy. Individual response to treatment varies. The information here is educational and is not a substitute for personalized medical advice from your Fountain clinician.

State availability

Fountain services and prescription products are available only in states where Fountain's affiliated medical practices are authorized to operate. Availability and specific protocols may vary by state. Your Fountain clinician will confirm whether this medication is available to you based on your state of residence.

Still have a question? Message the Fountain care team anytime! We're here to help.

Explore Fountain

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Vaginal Restore E2 Cream™ FAQs

Part 1: About Your Medication

Part 1: About Your Medication

Part 2: How to Use Your Cream

Part 2: How to Use Your Cream

Part 3: Side Effects & What to Expect

Part 3: Side Effects & What to Expect

Part 4: Understanding GSM

Part 4: Understanding GSM

Part 5: Safety and Who Should Not Use This

Part 5: Safety and Who Should Not Use This

Part 6: When to Reach Out

Part 6: When to Reach Out

Part 7: Refills, Storage, and Day-to-Day

Part 7: Refills, Storage, and Day-to-Day

A Final Word

A Final Word

Important Disclaimers

Important Disclaimers