She needed urgent help: estrogen cream and a vaginal estrogen pessary. Vaginal estrogen, whether a cream or pessary, can bring it all back to life. Many women also report urinary symptoms such as urgency, frequency, burning with urination, or recurrent urinary tract infections. Local vaginal estrogen therapy is often the most effective option, helping to restore moisture and elasticity to the tissues with minimal systemic absorption. WOMEN IN NURSING HOMESMany older women in residential care could significantly benefit from vaginal estrogen.