Potential risks for this study outside of the risks associated with pessary use are minimal. Complications with pessary use include: vaginal erosion, urinary retention, urinary incontinence and discomfort. These complications will be reviewed with the patient prior to insertion of pessary. Potential risks encountered when using vaginal estrogen are low. Estrace contains 0.1 mg estradiol per gram of cream. The recommended dosing is 2-4 g daily for 1-2 weeks, a gradual reduction to half the initial dose over 1-2 weeks, and then 1 g 1-3 times weekly for maintenance. Our patients will be using half the recommended daily dose for maintenance and at the most, 1/4th the recommended dose for priming the atrophic tissue.