Postpartum Vaginal Estrogen for Breastfeeding Patients

Inclusion Criteria:

* Age 18 or older
* Sexually active
* Singleton, term (37 weeks 0 days) birth
* Planning to breastfeed or pump during the study period
* History of successful breastfeeding or pumping after a prior pregnancy
* Between 6 weeks and 6 months postpartum (patients may be recruited at any time during the postpartum period, but the study period will not start until 6 weeks postpartum)
* Ability to consent in English
* Not meeting any exclusion criteria

Exclusion Criteria:

* Preterm delivery
* Perinatal mortality
* History of difficulty breastfeeding
* 3rd or 4th degree perineal laceration
* Any contraindications to estrogen, including, but not limited to, breast cancer or a history of breast cancer, estrogen-dependent neoplasia, active deep vein thrombosis (DVT)/pulmonary embolism (PE) or a history of these conditions, active arterial thromboembolic disease (for example, stroke and MI) or a history of these conditions, known anaphylactic reaction, angioedema, or hypersensitivity to estrogen, hepatic impairment or disease, protein C, protein S, or antithrombin deficiency, or other known thrombophilic disorders.