I use 1 gram of Estrace Cream three days a week. I receive a 42.5 g tube every three months. While the math is right, one tube seems to last only slightly more that 2 months. I use the applicator that comes with it, filling only to the 1 gram mark each time. Insurance does not allow me to reorder until the end of the 3 month period, which means I go without for 3 weeks. (I use this medication for an autoimmune disease and experience painful flares when I miss a dose.) Has anyone else had the same problem of running out of medication too soon? What am I doing wrong?
Estrace Vaginal Cream - Why does tube of medicine run out before the end of 3 months?
Question posted by LW44 on 5 June 2017
Last updated on 5 March 2025
The information on this page reflects personal experiences shared by our community members. It is not reviewed for medical accuracy and should not replace professional medical advice.
34 Answers Page 2
The same thing just happened to me. My doctor prescribed Estradiol, 2 g every day for two weeks, then after that 2 g once or twice a week. It's the end of my first two weeks and I am almost out of it! I suspect that the applicator is not accurate. Fortunately I have an appointment with my gynecologist next week so will discuss this with her.
I am so glad I found this discussion, thanks to the women who question things that seem wrong. I am a nurse practitioner with 30 years’ experience in measuring medications, yet I came up short of estrogen cream every single time. Theoretically a 42.5 gm tube should deliver 42.5 of 1 gm doses that are commonly prescribed. That would be 14 weeks if you are taking 3 doses per week.
I never took the time to calculate it, but was very aware that if I filled the applicator to the 1 gm mark, I would run out a few weeks early. This was true with the brand Premarin as well as the generic estradiol vaginal cream. I mentioned it to my excellent family practitioner who said that she had not heard this problem before. She now orders 2 tubes/90 days and my insurance pays without complaint, so I think they may be aware of problems with correct gram count.
Because I was extremely busy and because I did not feel that it was medically significant, I did what most women probably do: filled the applicator to about 3/4 gm instead of 1gm. It did not seem to make any difference in my symptoms. Topical estrogen is not systemically well absorbed through the entire body, so you would measure its effectiveness on vaginal symptoms (burning,dryness, painful intercourse.)
I have no idea how multiple manufacturers could all get away with underfilling the tubes, so am wondering if the applicators are the problem.
Same EXACT thing with me, it measures completely wrong so I ran out of it too soon and insurance didn’t cover it! Showed pharmacist, she didn’t understand it either. We really should start a Class action suit, find a Better call Saul lawyer. This screws with our hormones to just stop using for 2weeks and start again. And we’re PAYING for something we’re NOT GETTING, and our HEALTH is being screwed with, It’s criminal. I’m so glad to find you all, I’m taking this “evidence” to pharmacist, see what she says. Let’s look in to layers ok?
I observed a hole in the cream at the top of the tube, after realizing the tube was not fully filled. I contacted the mfg., they told me to go to CVS and return it. HA! CVS refused. I Filed a concern with CVS and await their phone call. In the meantime, almost out (way before I should be) and picked up another tube... GUESS WHAT! Same code numbers on this tube box! I'm not going to open it until I get refund and reimbursement. c o n t a c t m e t e x a s c a n e s a t g m a i l d o t c o m
It’s the applicator that comes in the box it measures almost double what it supposed to. The pharmacist said there’s nothing they can do I have to take it back to my doctor and show her. The Dr is the only one who can complain to the drug company that they’ll listen to. It’s so crazy the difference when measured . I bought a pack of new applicators off of Amazon and there is such an obvious difference between the correct new ones and the one they put in box. The new applicators are much thinner than the Estradiol one. It makes me so angry that we all kept running out and no one is doing anything! Well I am letting my Dr know next appt. You all should spend the 8$ and buy a pack of applicators and show your Drs as well.
It’s the applicator that comes in the box it measures almost double what it supposed to. The pharmacist said there’s nothing they can do I have to take it back to my doctor and show her. The Dr is the only one who can complain to the drug company that they’ll listen to. It’s so crazy the difference when measured . I bought a pack of new applicators off of Amazon and there is such an obvious difference between the correct new ones and the one they put in box. The new applicators are much thinner than the Estradiol one. It makes me so angry that we all kept running out and no one is doing anything! Well I am letting my Dr know next appt. You all should spend the 8$ and buy a pack of applicators and show your Drs as well.
I am having the same issue..something has to be done about this!
if you order the RX from a pharmacy in Canada you will pay substantially less - likely you will pay 15% of what you are paying now -
not 15% less than you are paying rather 15% of what you are paying.
it's exactly the same thing in exactly the same package
This is very interesting as I just filled my first prescription in at least a decade. What is everyone paying per tube? When I first got a prescription for this, it was $15 copay and a tube a month. Now I’m paying $168. Someone is making a heck of a profit on my vagina.
With my 2019 Medicare Drug plan I paid $141.00 for a tube of brand-name Estrace in July. After reading reports of the new generic Estrace that had become available, I didn’t want to change to the generic in 2019, so I chose the Medicare Drug plan I’m on for 2019 because it had brand-name Estrace on its formulary. For 2019 most all of the Medicare Rx plans no longer offered the brand, only the generic. Last year in Dec. 2018 when I was on a different Medicare Drug plan that offered the brand-name (that plan stopped offering the brand for 2019), I paid $72.25 for the same brand-name tube.
I am new here and glad I found this thread. I just started this Rx and what I've noticed is how when I twist off the top it oozes out a bit. After pushing into applicator, there's a bit left at bottom of applicator, and when I remove that, even more oozes out of tube. I can see how easily this waste will add up! There must be a way to make this a more secure fit. I hope our doctors adjust the Rx to a larger tube. I can't believe that it is a good thing to miss days of this medication.
I’ve found that with some tubes, the two parts of the applicator are a very tight fit, and you have to use so much pressure on the tube to get the inside piece of the applicator to slide up, that it causes the oozing and waste when you remove the tube from the applicator. So I set the applicator to the dose I want before attaching it to the tube, and I don’t have to squeeze so hard and there is no waste.
I started Estradiol cream 3 months ago, one tube to last 3 months, ran out in two months. Measured on gram scale and found out applicator 1 gm mark is not accurate, same as others have reported. I am going to report to FDA, I was surprised someone else did and said the FDA is not interested, this is part of their mission. Please report to FDA, the squeaky wheel gets the oil.
Further to my original comment post of Nov 12, 2018, I recently in 2019 spoke to my gynecologist about the Estrace applicator problem. As we all figured out, the applicator does dose way too much. My gyn told me not to worry that I’d been overdosing for years because the body only absorbs what it needs. Hope that’s the case! That being said, I use 1gr 3 times a week, which means one tube should last me 14 weeks, which of course it was never doing because of the faulty applicator. To get the correct dose and have the tube last the correct amount of time, I’m now eyeing about a 1/2” of the cream into the tube. I started the tube on April 3, 2019, and the 1/2” amount looks on target. Will know if I need to adjust a bit when I finish the tube.
I hope that this thread is still open and someone can give me the latest update. I've had the exact issue with Estrace (Allergan product) and also with the generic Estradiol (currently the generic I have on hand is manufactured by Teva). A pharmacist at Express Scripts informed me that there had been no other issues reported with Estrace 42.5, and that I was the first to have an issue with getting less than 42 doses. I contacted my GYN's office to make sure I was not overdosing. After taking the prescription and the applicator into their office, the nurse indicated that the applicator was confusing, and that I should "eyeball" it when filling the applicator. She indicated that the applicator as set up appeared to be giving me more than a 1 gram dose. I'm really uncomfortable with the whole situation and can't understand how the drug companies haven't made corrections -- either to the size of the tube or to the markings on the applicator.
Has anyone progressed in finding out how to proceed? I'm so glad I found this thread -- It wasn't easy! Obviously the drug companies keep the complaints hidden.
Further to my earlier post, I made an appointment and went in to see my GYN on this issue. As someone else on this thread indicated, my GYN said that there was no harm to me in over-dosing the medication for over a year. He did not want to see the applicator I brought to him, and said that no one else has complained about this issue. I really had the impression that he was not taking my complaint seriously. At least I have gone on record that I informed him that I know the applicator is incorrect and that I overdosed for over a year. He changed my prescription to Yuvafem, which is pre-measured and does not require re-use of an applicator.
My gynecologist has switched me to Vuvafem Inserts also. I am just wondering if the Vuvafem 10 mcg and the Estradiol cream 0.01% is the same but in a different form, or is one stronger than the other.
Oh my goodness. This cream lasts me a week. I have been putting 4x as much as I should. Maybe that's why it hasn't been helping. My tube has markings that I did not understand. I am down with a suit because it is just so cheap of them to give us one applicator. This drug is too expensive for that. The women on here may have saved my life. Thank you.
If you contact your state Department of Consumer Affairs, they will send you or email you a complaint form to complete. You might want to send a copy to your state attorney general also. I don't think it will help as nobody wants to fight with Big Pharma but it can't hurt. I'm in if anyone wants to file a class action lawsuit.
I only got 23 grams out of a 42.5 gram tube.
Glad to find this thread.
I have difficulty with filling the applicator. After I squeeze Estrace cream into it and when I disconnect the applicator from the tube the pressure inside the tube cause the cream to squeeze out, sometimes it’s about 1gr or more. To prevent it from happening and the waist, now I put my finger on top of the tube opening immediately after I remove the applicator but it doesn’t seam right. Also it’s very hard to clean the applicator between use, need to use toothpick and Q-tips to try take off leftover cream. Also one time when the tube was half empty ,I folded it to be able to squeeze better and the tube broke on the fold. I wold love to get contact info for person in the drug company to relate this issues with them. Thank you
So glad I accidentally came across this thread! Yes, the applicator’s dosing is disturbingly and dangerously incorrect! I was prescribed 1 gram Estrace Vaginal Cream three times per week a number of years ago and have been taking that dose every week for a long time. It wasn't until about a year or so ago that I realized that the applicator was dosing too much. I had unfortunately trusted it! Because my Medicare drug insurance always refills this script whenever I need a refill, I hadn’t thought about how many doses I should truly get from the 42.5 gr tube. I was overdosing for years because of Allergan’s negligence! This is unacceptable and dangerous. Allergan, who makes Estrace, needs to be held accountable. We need to do a class action lawsuit.
Yeah, I just went over this with my pharmacist. I explained exactly how I was measuring the dose. But I ran out a week and a half before I could refill. I said the application must be wrong. He explained a gram was about the tip of your little finger. So that seemed about right. I can't figure it out nor can I find any other websites that mention this.
My concern is, instead of increasing the dosage in the prescription to account for the "missing" cream, shouldn't we be using less? The tube said the grams in it, so it should last that long. It sounds to me as though everyone is over dosing it.
I've been having better luck by using slightly less than one gram, as measured in the applicator. I fill it to slightly less than one gram, and I also hold the end of the applicator with my other hand when I squeeze the cream into it, so that it doesn't slip and permit more cream to enter it. You have to be very frugal with the cream, that's the only way it will last the full time.
I have had the same issue. I take one gram twice a week, and the 28 doses per tube sounds in line with what I was finding. On the second tube, the pharmacy gave me a ”vacation emergency refill” but that was all used up in early June and the pharmacy said my next refill couldn’t be until August! I spoke to my gynecologist and she rewrote the prescription for three times a week... I’m still to use it only twice a week but will be able to refill sooner. So grateful she believed me and was willing to work with me for a reasonable solution.
Yes, the only solution is to have your doctor prescribe more than you actually will take... there is. It other way.
I have tried to fight this issue with the company as you can see when you read my past posts.
Finally gave up.
This is truly mysterious and very frustrating. According to her nurse, my GYN has never heard of this issue before. I called the company that makes the generic equivalent, and they very kindly sent a credit to my pharmacy, and the pharmacy gave me a free tube. I am absolutely sure that I'm not using too much, so I guess I'll see what happens with this one. If it runs out too early again, I guess I'll either give up on it or make an appointment to see my doctor and perhaps she will do the same thing that yours did.
I took Vagifem for years but my new doctor thought the cream would be more reliable. Since prescription plan will no longer be available in 2019, I have been investigating the only option available which is through Medicare D. I was astonished to realize a year supply of Estradiol 0.01% cream would cost $250 co-pay for a three month supply compared to the $50 co-pay I am currently paying. Why is this cream so expensive? I also have the same experiences as others in that the cream does not last for three months. I almost have to stand on the tube to get the last amount out. At first I filled the tube completely as prescribed but soon realized the supply would be gone before I could refill. Mylan is the company that distributes mine. I am going to contact them and if I gain any useful information, I will share.
Yes, that is the only way to get around this issue..I called the company so many times but to no avail..
I feel like going to a new commentator about this.
I finally decided to just stop taking it
The next time I go to my GYN (assuming I'm still using the cream), I'm going to print out this these comments and bring them with me. There has to be something to this, if this many people have had exactly the same issue.
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estrace, estrace vaginal cream, medicine, cream, vagina
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