Did you know that if you’re using systemic therapy like a patch, spray, gel, or pill, you can absolutely add local vaginal estrogen too? . About 40 percent of women on systemic therapy still need a local option to treat their genitourinary symptoms of menopause. One does not replace the other- you can safely use both together. . 💖 Click the link in bio to grab your copy of The Perimenopause Survival Guide. | Heather Hirsch MD MS NCMP