I was experiencing severe vaginal dryness that did not respond natural treatments so my doctor prescribed the Estring. The Estring did not work either. I had read online that sometimes using a little testosterone can enhance the effectiveness of the Estring. I discussed this with my doctor who agreed to order compounded testosterone for me to try. She instructed me to use a very tiny amount and it worked like a charm! I am a 79 year old retired nurse and have been using this medication for about 8 to 10 years with no problems.