Hi, dont know if this helps anyone, i used vagifem and when i first started thought it was great, then when i had to reduce dose, it didnt work so well, then i upped the dose, after this i got it settled for a while, then i never seemed to get it right. i wished i had done what some other ladies had done use a moisturiser inbetween doses. but i increased the dose on the advice of gynacologist to every day, boy that upset me in my opinion. but that is my personal opinion not a gynacologists. I have now moved onto the estring. this is worth trying ladies, it is clean and easy to insert. yes it is large, but then you dont want to loose it... lol.. initially it is uncomfy, but i found the way to deal with this, was pop it in till you have had enough and pop it out again, you are in control. you will find you will be able to leave it in longer as you get used to it and i dont have any skin interaction where a tablet is sitting inside.. you wash it off in cold water and put it away. great... i like the estring x