The cream is used topically to reduce/clear up a caruncle, which I had for almost a year before it was finally diagnosed by a urologist. Although using the Estradiol cream took about six weeks to begin eliminating the discomfort and clearing up the caruncle it has made a world of difference, and after a year I have been able to reduce the use of Estradiol to one night a week, rather than three. However, it seems I will need to use Estradiol probably for the rest of my life. The cost to purchase compounded Estradiol is remarkably cheaper than using a manufactured hormone therapy drug. I feel Estradiol is a more natural product, not so much chemicals.