By: Patricia Durate, Mindful Agency
In this conversation, Dr. Sarah Daccarett, founder of Inner Balance, discusses the science of vaginal hormone delivery and the thinking that shaped her approach to Oestra™.
Most people think of vaginal estrogen as “local only.” What’s the biggest misconception you want to clear up?
The idea that vaginal therapy isn’t systemic comes from low-dose products designed for dryness. Those microdoses shouldn’t raise blood levels, which is by design. The route itself, however, is capable of systemic delivery. Researchers studying hormonal contraception and fertility protocols have long demonstrated that the vaginal mucosa supports absorption of compounds into systemic circulation. With the right dose and formulation, vaginal hormones can show up in the blood and act throughout the body.
So what makes Oestra™ different from other hormone therapies?
Oestra™ is formulated with systemic absorption in mind, not as a dryness cream. It is a full-body hormone therapy delivered vaginally rather than orally or topically. Vaginal delivery bypasses first-pass liver metabolism, which is part of why pharmacology research has long examined this route. Estrogen and progesterone influence many systems, from mood and metabolism to brain function and bone density. The formulation is built around that broader physiological picture.
What’s the philosophy behind the formulation?
Comprehensiveness. Estrogen and progesterone influence many body systems, so an effective therapy should be designed to support hormones consistently rather than fragmenting care across separate products. The model behind Oestra™ reflects that thinking, with the goal of pairing systemic delivery with a once-daily routine.
Many women look to direct testosterone therapy for libido concerns. What’s the framework behind your approach?
Progesterone naturally converts into testosterone in the body. It is a known physiological pathway. The thinking behind Oestra™ is to support that natural conversion rather than introducing direct testosterone, which can carry side effects such as acne and hair changes. The intent is a more physiologic framework.
What guides your design philosophy for Oestra™?
Respecting women’s biology. Hormone therapy should aim to avoid overloading the liver, support steady hormone levels rather than spikes, and account for the full range of estrogen and progesterone functions. That framework is what Oestra™ is built around. That is what medicine should aim to do.
What’s your vision for Inner Balance?
To change the way women think about hormones and the way medicine treats women. We are building therapies, education, and a care model designed to support women through hormonal transitions. Oestra™ is just the beginning.
Disclaimer: This article is for informational and educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for guidance from a qualified healthcare provider. Hormone therapy is a prescription treatment, and decisions about whether it is appropriate for you should be made in consultation with a licensed physician based on your individual medical history. Individual experiences vary.
