That proverbial desert of midlife and beyond can now be treated with a lower dose of Vagifem, 10 mcg of bioidentical estradiol versus the previous dose of 25 mcg.  The loss of estrogen associated with menopause causes shrinking, thinning, and decreased lubrication of the vaginal walls.  This lower dose of Vagifem alleviates the dryness, pain with urination, and painful intercourse in most women as well as the higher dose by delivering a small amount of estrogen directly to the vagina via a small tablet inserted with an applicator.  Premarin Cream is NOT the same product, it is made with “conjugated estrogens” that are NOT identical to your natural estrogens.