For decades, women have been offered a fragmented, outdated, and often ineffective approach to hormone therapy: a patch here, a pill there, a cream for dryness, and a separate product for libido or sleep. But a growing wave of women’s health innovators—supported by new biochemistry, updated clinical evidence, and a generation of women demanding better care—are rewriting the rules.
Leading that movement is Inner Balance, the women’s hormone health company founded by Dr. Sarah Daccarett, MD. Their flagship treatment, Oestra™, is now emerging as one of the most disruptive innovations in modern hormone therapy. And according to new data from Inner Balance’s internal observational study, the impact is nothing short of remarkable.
A Smarter Form of Hormone Therapy—Delivered Vaginally, Designed to Be Systemic
While most vaginal estrogen creams are low-dose, designed only for dryness and intentionally not systemic, Oestra™ flips that concept entirely.
Oestra™ uses the vaginal route on purpose to deliver systemic estradiol and progesterone—achieving full-body hormone effects without burdening the liver or creating the hormonal spikes associated with oral or transdermal therapies.
“Women deserve a hormone therapy that supports all of their systems—mood, metabolism, sleep, libido, brain, bones—not just vaginal tissue,” says Dr. Sarah Daccarett, Founder and Chief Executive Officer of Inner Balance. “Oestra™ was created to do exactly that.”
The Internal Results Are In—And They’re Extraordinary
After six months of treatment, women using Oestra™ reported improvements across virtually every major hormone-related symptom:
Oestra™ Study Highlights
96% saw improvement in heavy or painful menstrual bleeding
97% reported improvement in vaginal dryness
75.3% saw improvements in sex drive and arousal
78.7% reported better mental health and mood
80.2% experienced improved sleep
69.7% saw better skin and hair appearance
23.5% reported weight loss
63% improved energy levels
67.6% improved brain fog
58.8% improved body aches and pains
“This is what happens when you deliver hormones the way the body recognizes,” Dr. Daccarett notes. “The route matters. The dose matters. The formulation matters.”
Inner Balance
Why Oestra™ Works: The Science Behind Vaginal Systemic Delivery
A widespread myth in medicine is that vaginal delivery is “local only.” In reality, that misconception comes from studies of microdose vaginal estrogen products—formulated intentionally to avoid systemic absorption.
But the vaginal route itself is fully capable of systemic delivery, and the evidence is overwhelming.
The biological reasons vaginal delivery works systemically:
Highly vascular tissue
The vaginal wall contains dense blood vessel networks that absorb hormones directly into the bloodstream—bypassing the stomach and liver.
Bypasses first-pass metabolism
Oral hormones are heavily metabolized by the liver, creating unwanted byproducts (like estrone). Vaginal delivery avoids this and provides cleaner, more active hormone levels.
More efficient bioavailability
Studies show ~70% of estradiol absorbed vaginally remains in its active “unconjugated” form, compared to roughly 35% when taken orally.
“First uterine pass effect”
Hormones placed in the upper vagina reach the uterus first—useful for progesterone, which protects the uterine lining.
Everyday contraceptive rings prove systemic absorption
Millions of women have used vaginal contraceptive rings that prevent ovulation—something only possible with systemic hormone levels.
“This is not new science,” says Dr. Daccarett. “Medicine has known for decades that the vaginal route can deliver medications systemically. The problem is that the products available were designed not to be systemic. Oestra™ simply uses this route the way it was meant to be used.”
The ELITE Trial: Strong Safety Data for Vaginal Progesterone
When considering long-term safety, the ELITE Trial—a five-year randomized controlled study—remains the gold standard. Its findings are foundational to Oestra™’s clinical design:
Women taking vaginal progesterone + oral estradiol saw no increase in endometrial cancer risk compared to placebo.
The combination also improved cardiovascular markers, suggesting reduced heart disease risk.
“Oestra™ uses the same delivery concept as ELITE—vaginal progesterone for uterine protection—but with a more advanced, body-matched formulation,” explains Dr. Daccarett. “It’s both safe and incredibly effective.”
Three Bioidentical Hormones. One Smarter Cream.
Oestra™ contains Estradiol (E2) and Progesterone. Both work together to reduce symptoms of (peri)menopause and aging like low motivation, energy, libido, sleep and metabolism – just to name a few. “We were thrilled to see that Oestra™ increased our patients’ testosterone levels—not through giving testosterone, but through restoring progesterone to its physiologic role,” says Dr. Daccarett. “It’s a more elegant way to support libido and vitality.”
Replacing the Patchwork of Hormone Therapy
Traditional hormone replacement often requires:
an estrogen patch
a progesterone capsule
a vaginal cream
a testosterone gel
Oestra™ replaces all four with one daily pearl-sized dose.
“Women are exhausted from piecing together treatments,” says Dr. Daccarett. “Oestra™ brings everything together in one calibrated formula designed to restore true balance.”
Inner Balance offers:
telehealth evaluation by trained women’s health clinicians
Options to titrate up on the dose
ongoing tracking and support
secure messaging
doorstep delivery
a 6-month improvement guarantee
“At Inner Balance, we don’t hand women a prescription and disappear,” Dr. Daccarett says. “We walk with them. Hormone therapy is a journey—and no woman should go through it alone.”
Inner Balance
A New Standard in Women’s Hormone Care
Oestra™ is more than a product—it is redefining how women experience hormone therapy.
By using a smarter delivery system, clinically calibrated bioidentical hormones, and a modern telehealth model, Inner Balance is raising the bar for what women should expect from their hormone care.
And the results speak for themselves.
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