I started out many years ago using Estrace cream, due to vaginal dryness. Using a coupon through Estrace, I got it for $10 a tube. Then when I used Medicare they denied Estrace cream and only offered Estradiol cream; cost right at $140/tube. Right after I was diagnosed with Lichens Sclerous disease and noticed the Estradiol cream caused added irritation to this disease. My OBGYN suggested using a compounded estradiol formula, it only has estradiol and vanicream as a additive in it. Whereas, prescription estradiol has multiple additives. Since going on the the compounded estradiol my quality of life went up tremendously. No added irritation to the complications of Lichen Sclerous and it has saved me so much in prescription cost. This has been a true blessing since I am on a fixed income. I pray they do not take the compounding option away.